Revenue Management Services for Hospitals and Physician Groups
Verify Benefits and Eligibility for your patients in the fastest way possible.
Enhance RCM with Patient Eligibility Verification Services
Improve your revenue cycle management with our patient eligibility verification services. Simplify and expedite verification, ensuring accurate benefits checks for patients. Utilizing advanced tools, we minimize delays, reduce errors, and maximize revenue.
Our services cover various data acquisition methods, including EHR/EMR integration and third-party scheduling apps. We verify critical registration details like member IDs and coverage information. Our automation tool corrects errors and updates data efficiently.
With experienced staff, we stay updated on payer guidelines and verify eligibility before claim submission. Our automation ensures 24/7 verification, leading to cost savings and operational efficiency.
Quick Inquires Form
Health Insurance Carrier Status
Health Insurance Plan Type
Group Numbers
Dependent Covered Under The Plan
Insured Contact Details If Any
Dedectible
Covered And Non-Covered services Information
Copay Details
Pre-existing condition waiting period if any
REFARALS
Pre-authorization check for services
Plan limitation and exclusion
Expert Eligibility Verification Staff
Pathway HMS initiated its eligibility process 14 years ago and boasts the most seasoned verification staff. Each member possesses over 5 years of experience and undergoes regular training to stay abreast of changes in payer guidelines, new and merged payers, out-of-network provider eligibility, and other updates.
One-In-One Eligibility Platform
Pathwayhms offers an integrated solution to prevent denied eligibility claims. Our innovative cloud-based software conducts proactive patient eligibility verification before claim submission, significantly minimizing the chances of denial. Verify hundreds of patient eligibilities within minutes with ease.
Prior-Authorization Verification In Patient Eligibility Services.
Our RPA technology led to a revenue boost of $3.5 million for a healthcare system in Northern Georgia, comprising three hospitals with a total of 245 beds. We successfully identified coverage for 4,649 self-pay patients, achieving a cost savings of 60%. With 24/7 unattended eligibility verification, our technology ensures seamless operations.
- Notification and resolution of rejection of authorization application.
- Follow-up of the authorization request.
- Submission of authorization paperwork to insurance.
- Prior-authorization determination and requirements.
EV FTE Resources
Our committed team vigorously contests and effectively manages denials with a hands-on approach. Our account specialists diligently work to produce results. Equipped with the unique ability to coordinate across all payer platforms, our personnel ensure increased revenue streams. They receive regular training to stay updated on evolving payer specifications. We adhere strictly to compliance measures and securely handle confidential data aggregation.
Automated Patient Eligibility Software
We offer our clients a reliable cloud-based software that automates processes and addresses all aspects of patient eligibility. This software provides cutting-edge IT support and enhances revenue generation. We streamline and enhance your current RCM strategy through automation, with our skilled personnel conducting a thorough review to ensure top-notch performance. Our solutions are seamlessly scalable to meet your specific demands. All these impactful and efficient products are available at a highly cost-effective rate.
A Case Study, on how BillingParadise tackles Patient Eligibility Verification Denials.
Learn how our dedicated experts contest your denials. Get all the information on how our optimized and proprietary software is implemented to terminate your front end bottlenecks
Escalate Receivables
Reduce Write Offs
Increase Profits
No More Mismatch Denials
Proper Collection Off Patient Dues Upfront
Efficient Automation Process
What is included in the Patient Eligibility Verification and Benefits Services?
Obtaining workflow data through various methods:
- Patient data from EHR/EMR or third-party scheduling applications
- Manual patient data files such as FTP, email, fax, etc
Health Insurance Verification of basic patient registration information:
- Member and group ID
- Primary and secondary coverage details
Patient data correction and automation:
- Fixing invalid patient data.
- Eligibility and benefits information updating using our proprietary eligibility automation tool.