Eligibility and Benefits Verification Services.

Eligibility & Benefits Verification Services

Ensure financial clarity, minimize denials, and optimize patient care from the very start with our expert eligibility and benefits verification services.

Step Into Smarter RCM with I-Conic Solutions


Stop Revenue Loss

Medical practices lose $125 billion annually to claim denials, with 65% caused by insurance eligibility and benefits verification failures. Are you facing 15-20% denial rates and frustrated patients receiving unexpected bills after treatment? Without proper benefit verification in medical billing, practices struggle with revenue loss while patients abandon care due to billing surprises. Complex prior authorization requirements and changing insurance policies create costly administrative burdens that drain your resources. I-Conic Solutions prevents these issues by verifying coverage, authorization needs, and patient responsibility upfront, ensuring smooth billing and satisfied patients.

Why is it Important to Verify

Robust insurance verification services provide a powerful shield, making this proactive approach fundamental to sound Revenue Cycle Management.

Our thorough patient eligibility verification proactively identifies issues (inactive policies, expired coverage, missing authorizations), significantly cutting down on claim denials and costly re-submissions.

Clarifies financial obligations (co-payment, deductible, policy limits) upfront, minimizing unexpected bills and fostering trust.

Expedited claim processing and fewer rejections mean faster reimbursement and a healthier bottom line. Effective eligibility verification in medical billing optimizes revenue.

Provides clear verification reports with accurate, up-to-date insurance information for informed decisions by both your team and patients.

Frees your front-desk staff from endless payer calls. Our insurance eligibility verification services streamline workflows, saving valuable time.

Meticulously documented benefit details provide robust support for audits and ensure compliance.

Eligibility and Benefits Verification

Step 1: Patient Data Intake
We securely receive patient demographics and scheduled appointments.
Step 2: Real-Time Eligibility Checks
Using real-time eligibility checks through advanced payer portals & secure clearinghouses, we confirm active coverage, like medical insurance verification websites.
Step 3: In-Depth Benefits Verification
Verifying insurance benefits, including all essential co-pay/deductible details capture, co-insurance, out-of-pocket maximums, and policy limitations.
Step 4: Prior Authorization Assessment
We identify if prior authorization is required for the scheduled services, noting all specific payer requirements.
Step 5: Out-of-Network Alerts
Our system provides proactive out-of-network alerts if a patient's plan has limited or no coverage with your facility.
Step 6: Direct Payer Engagement
For complex cases or ambiguous policy details, our specialists contact insurers directly for the most accurate information.
Step 7: Reporting & System Updates
We create and share detailed verification reports, which we use to update your practice management system for accurate billing.

Potential Consequences of Failing to

High Claim Denial Rates

Delayed Patient Collections

Increased Accounts Receivable (AR)

Negative Patient Experiences

Administrative Rework

Cash Flow Instability

Audit Exposure

Our End-to-End

Proactive Eligibility Checks
Verify the patient’s eligibility and benefits, and obtain prior authorization determinations before the patient visit, flagging services that require pre-approval.
Verify Patient Demographic Information
Essential for accurate claims processing.
PMS System Updates
Update your practice management system with the approvals and other information received from the payer for seamless integration.
Payer Portal Follow-ups
Dedicated follow-ups for approvals through the payer’s portal, ensuring timely responses.
Primary & Secondary Payer Coordination
Verify coverage of benefits with the patient’s primary and secondary payers, providing a complete financial picture.
Denial Prevention & Insights
Thorough eligibility verification insights can inform claim denial appeals by identifying the root cause of rejections tied to upfront verification.

Outcomes

Partnering with I-Conic Solutions for your eligibility verification process in medical billing delivers measurable improvements.

35% Reduction

in Claim Denials

40% Improvement

in Front-End Collections

30% Reduced

Patient A/R

50% Increased

Patient Satisfaction

Top 10 Reasons to Outsource Eligibility and Benefits

To outsource insurance eligibility verification services to us offers unparalleled advantages for your Revenue Cycle Management

Our dedicated experts ensure precise verification, minimizing errors that lead to denials.

Reduce operational overhead, labor costs, and the expenses associated with claim denials.

Faster verification means quicker claims, leading to improved reimbursement speed.

Benefit from a highly trained team specializing in medical insurance verification across diverse payers.

We leverage sophisticated payer portals and clearinghouses for efficient, real-time eligibility checks, akin to the best medical insurance verification websites.

Free your internal staff to concentrate on what matters most – delivering exceptional patient experiences.

Our services adapt seamlessly to your practice’s growth and fluctuating patient volumes.

We handle co-pay/deductible details capture, out-of-network alerts, and policy limitation checks for a complete picture.

All benefit details are meticulously documented, providing crucial audit support.

We act as an extension of your team, committed to your long-term Revenue Cycle Management success.

Take the First Step with I-Conic Solutions

Your revenue cycle deserves more than just management; it deserves transformation.

Our

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