Patient Eligibility Verification

Helping providers in submitting clean claims

Our Pre-Authorization and Eligibility Verification Services Are All You’ll Ever Need!

Patient Eligibility Verification is considered to be an initial step in the revenue cycle management that enables medical practices to see whether a patient is eligible for the treatment. It includes the breakdown of benefits and checking whether the healthcare service is covered by the patient’s insurance or not, along with other benefit options such as copays, deductibles, and co-insurance as well. Verification of Eligibility is highly crucial to a medical practice overall. According to reports, approximately 70-75% of claim denials occur primarily due to errors or mistakes in the eligibility verification of patients by healthcare providers. This shows us that most practices are still not paying due attention to their eligibility verification processes, and paying its price in the form of claim delays and denials. Nevertheless, we at RJMedex LLC are providing medical practices with a solution. Our Eligibility Verification services for physicians and private practices are devised to provide you with leverage in the medical billing domain.

Eligibility Verification is More Important Than You Might Think!

Many physicians and private practices think of eligibility verification as a formality that is mostly overshadowed compared to the other steps in the revenue cycle management system. This is why the highest rates of claim denials are caused due to mistakes in a patient’s eligibility verification. To further add insult to injury, the claim denials are mostly non-appealable and irreversible because they fall in the category of hard denials. As a result, medical practices have to bear monetary costs along with a highly negative impact on the healthcare practice’s overall reputation as well.

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Why Outsource Eligibility Verification Services

As mentioned earlier, the first and foremost phase of the medical billing process is eligibility verification. A practice can only receive timely payments if insurance verification is done correctly. As a medical practice, you need to verify the patient’s eligibility before rendering any service. In case you fail to address the eligibility verification problem at the earliest, you are going to face delayed payments and even denials. As a result, it leads to lesser revenues and greater claim denials. This is where our Eligibility Verification services come in handy as you can easily hand over the job to our experts and focus on patient care for the best results

Benefits of Outsourcing Eligibility Verification Service

Here are some of the major benefits of outsourcing eligibility verification with RJMedex LLC.

Claim Denials Avoided

By outsourcing pre-authorization and eligibility verification, you can easily focus on the bottom line and avoid errors in the system leading to claim denials.

Low Operational Costs

We realize that in-house verification can be highly costly and therefore, our services are highly affordable and provide you with cost-effective alternative.

Easy to Scale Business

Our eligibility verification services for private practices are such that they provide physicians with critical leverage for them to scale their practice to the next level.

Improve Patient Care

Introducing efficiency into the initial phase of the revenue cycle management, we enable practices to focus on patient care, leading to patient satisfaction.

Our Eligibility Verification Experts Are Just a Call Away!

Our experienced eligibility verification consultants provide superior eligibility verification services to help you avoid claim denials. We handle end-to-end insurance verification in which we keep an eye on the coverage and benefits from the insurance providers to eradicate any chance of error or mistake. As a result, our claim submissions are highly accurate, leading to increased medical practice and patient satisfaction.

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Helped Over 100+ Medical Practices "Reviews & Testimonials"

Amos Cosar

Chiropractor

Angie Hastings

Internal Medicine

Angie Hastings

Family Practice

The guys at RJMedex Claims are really professional and always available for help and assistance and provide us with quality billing services. They’re the best medical billers for your custom needs, even if you’re on a budget.

“ RJMedex Claims team helped us with quick claim processing and claims are always scrubbed, which reduced denial rates. We have a decent claim acceptance rate now. They exceeded our expectation on everything related to billing. ”

“ We’ve found RJMedex Claims’ chiropractor billing experts to be on point with the overall claim filing, coding, and reimbursements. They’ve helped us grow our revenue by manifolds. ”

4.9

Zocdoc Overall Rating , based on 7541 reviews.

Eligibility Verification FAQs

Medical practices have to make sure that the healthcare services they’re offering are actually covered by the patient’s insurance. This is why they have to perform eligibility verification for the purpose.

The term Breakdown of Benefits (BOB) is used to represent the act of checking for co-pays, deductibles, coinsurances (%), or other non-covered amounts that are to be paid to medical practice or physicians by patients.

RJMedex is a professional RCM Billing company that ensures proper eligibility verification and breakdown of benefits for medical practices to avoid any chance of claim denials affecting a practice’s overall revenue.

The usual time required for verification of benefits takes 20 minutes. However, it is recommended that you get in contact with the payer 72 hours before the appointment of the patient.