Eligibility Verification & Prior Authorization
Overview
Industry experience shows that one of the key reasons for claim rejection is patients not being eligible for the services rendered by the healthcare provider. Incorrect or incomplete eligibility of benefits verification can lead to an increase in claim denials which will delay payments or even non-payment of claims. Sometimes, this can also cause a delay in rendering timely healthcare services. That’s why eligibility verification and prior authorization become critical - both for the healthcare service provider as well as the patient.
Soft Logan’s Eligibility Verification and Prior Authorization service helps to
01.
Facilitate accurate and timely receipt of information regarding a patient’s insurance coverage.
02.
Verify coverage of benefits with the patient’s primary and secondary payers
03.
Identify identification and resolution of missing or invalid data
04.
Initiate prior authorization requests and obtain approval for the treatment when (and if) required
05.
Update the hospital’s revenue cycle system with the details obtained from the payers
06.
Follow-up until authorization is received once the forms are filed.
Our team will take you through the step-by-step process that is followed in our eligibility verification and prior authorization and how it helps to reduce coverage errors, minimize rejections, and improve bad debt write-off scores