25 Years Of Experience
What We Do – Insurance Verification
At Advantawise, we understand the importance of accurate and timely insurance verification in ensuring the financial health of healthcare providers. Insurance verification is a crucial step in the revenue cycle management (RCM) process, ensuring that a patient is eligible for coverage before services are rendered. This step minimizes claim denials, reduces operational inefficiencies, and speeds up the reimbursement process.
Our Insurance Verification service helps healthcare providers prevent costly claim denials by verifying patient insurance eligibility, confirming coverage details, and ensuring that the right payer is billed. This process helps reduce billing errors and delays, ensuring that your claims are processed smoothly and efficiently.
How Our Insurance Verification Process Works
At Advantawise, we employ a thorough and efficient process for verifying insurance eligibility:
01
Receive Patient Information
We receive patient details through secure channels such as EDI, email, or fax, including their insurance policy and appointment schedule.
02
Verify Insurance Coverage
We check the eligibility of the patient for both primary and secondary insurance using reliable platforms like WebMD, payer websites, automated voice responses, and direct communication with insurers.
03
Patient Outreach
If necessary, we contact patients to obtain additional details to complete the verification, such as policy number, coverage dates, and co-pay information.
04
Reporting and Communication
Once verified, we provide a detailed report that includes essential insurance information such as member ID, group ID, coverage start and end dates, co-pay amounts, and any special instructions for claims processing.
05
Clean Claims Submission
Armed with accurate eligibility data, we ensure that claims are submitted correctly and promptly, reducing the chances of denials and rework.
Benefits of Our Insurance Verification Service
By leveraging our insurance verification services, healthcare providers can benefit in several key ways
Fewer Claim Denials
By ensuring that insurance coverage is verified before services are provided, we reduce the chances of claim denials related to eligibility issues.
Faster Reimbursement
Accurate eligibility verification helps prevent delays in claim processing, leading to quicker payments and improved cash flow.
Operational Efficiency
Automating the insurance verification process allows your team to focus on patient care and other core tasks, improving overall practice efficiency
Reduced Rework
By catching errors early, we prevent the need for costly rework that arises from incorrect or missing eligibility information.
Better Patient Experience
Patients are informed upfront about their coverage and financial responsibilities, reducing confusion and enhancing patient satisfaction.
What We Verify
Our team ensures that all critical details are verified for both primary and secondary insurance coverage
Primary and Secondary Payers
Verifying the eligibility of all payers involved
Member ID & Group ID
These identifiers are essential for correct billing.
Coverage Dates
We verify start and end dates for the insurance coverage.
Co-Pay Information
Understanding the patient’s co-pay helps with accurate billing
Pre-Authorization & Referral Requirements
We ensure that pre-authorization numbers and referrals are obtained if necessary.
Eligibility & Benefits
We confirm if the services the patient is seeking are covered by their insurance.