Insurance Eligibility & Benefits Verification Services

Confirm insurance coverage, co-pays, deductibles, and patient responsibilities before service to prevent claim denials.

Proven Results

Common Challenges

Insurance Verification Denials

Claims denied due to inactive coverage, incorrect policy information, or services not covered under patient benefits create costly rework.

Time-Consuming Manual Process

Staff spend hours on hold with insurance companies verifying coverage, taking time away from patient care and other critical tasks.

Patient Financial Surprises

Failure to verify benefits upfront leads to unexpected patient bills, collection problems, and damaged patient relationships.

Authorization Requirements Missed

Services requiring prior authorization are performed without approval, resulting in complete claim denials and zero payment.

Incomplete Coverage Information

Partial eligibility checks miss critical benefit details like deductibles, co-pays, and coverage limitations leading to payment issues.

Day-of-Service Verification Gaps

Insurance coverage changes between scheduling and service date go undetected, causing point-of-service collection problems.

Our Solutions

Real-Time Eligibility Verification

Automated electronic verification system checks insurance eligibility and benefits in real-time for every patient appointment.

Comprehensive Benefits Analysis

Detailed review of patient benefits including deductibles, co-pays, co-insurance, and coverage limitations for planned services.

Prior Authorization Management

Proactive identification and management of services requiring prior authorization to prevent denials.

Day-of-Service Re-Verification

Re-verify insurance coverage on service date to catch any coverage changes that occurred after initial verification.

Service Features

Insurance Eligibility Checks

Real-time verification of active insurance coverage and policy details for every patient encounter.

Benefits Verification

Detailed analysis of patient benefits including financial responsibility and coverage limitations.

Authorization Tracking

Identification and management of services requiring prior authorization or pre-certification.

Patient Responsibility Estimates

Accurate estimates of patient financial responsibility for planned services.

Client Testimonial

We were drowning in eligibility denials - over 28% of our claims. Medtransic's real-time verification system reduced that to under 4% in just three months. Our staff is no longer on hold with insurance companies, and patients appreciate knowing their costs upfront. It's been a game-changer.

Related Billing Resources

Key Services

Contact Medtransic today for expert eligibility verification services. Call 888-777-0860 or visit https://medtransic.com/contact for a free consultation.