Eligbility Verification

Eligibility verification is a critical step in the revenue cycle management process, ensuring that healthcare providers can determine a patient's insurance coverage and understand the requirements for prior authorization. At WE-PRO RCM Solutions, our Eligibility Verification Services are designed to streamline this process, prevent claim denials, and improve the overall financial health of your practice.

Key Features of Our Eligbility Verification Services

Insurance Coverage Verification:
Our team verifies a patient's insurance coverage, including details about the policy, coverage limits, deductibles, copayments, and coinsurance. This information is crucial for accurate billing and claims submission.

Prior Authorization:
We determine if prior authorization is required for specific medical procedures or services. This proactive approach helps prevent claim denials and ensures that patients receive the care they need.

Verification of Patient Information:
We verify patient demographic information, ensuring that patient details are accurate and up-to-date. This minimizes administrative errors and helps prevent claim rejections.

Real-Time Verification:
Our services often involve real-time verification, allowing for immediate confirmation of a patient's insurance eligibility and coverage details during the scheduling or check-in process.

Continuous Updates:
We stay current with insurance companies' guidelines and requirements, ensuring that you receive accurate and up-to-date information for each patient's insurance coverage.