Patient Eligibility Verification

Patient Eligibility verification: You need a team to step up to the plate !

Checking patient's eligibility prior is essential to avoid denied claims. BillingParadise offers medical practices a thorough and efficient, insurance eligibility verification process. We closely scrutinize pertinent details that are used to create a claim such as

  • Name of insurance carrier and policy
  • Previous balance of the patient
  • The eligibility status: Active or inactive
  • Whether the patient is in the providers network
  • Insurance coverage
  • Co-pays and deductibles

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To save your time, and to get quick response from insurance carriers, the team at BillingParadise offer 24/7, insurance eligibility verification services.

BillingParadise logs into the EMRs of the doctors clinic two days prior to a visit, to get information such as patient's name, insurance carrier name, policy covered and patient's balance if any.

BillingParadise then logs in to the insurance carriers website and checks through information such as eligibility status whether active or inactive, whether it is a first time visit or not, the effective date and the termination date of the insurance plan, co-pays which differ for a primary and a speciality encounter, deductibles, and whether the provider, primary or specialist is in the network or out of the network of insurance carriers.

Thus if there are any issues with the patient's insurance, balance to be paid or co-pays for a primary or specialist visit, BillingParadise sends the detailed information to the doctor and the patient if required.

Most of the billing teams or your staff would be following the same steps but do they check these critical points ?

  • The expert checks whether the service is pre-authorised, as for some treatments the authorisation time shuts down within thirty days. Therefore the team submits the claims before deadline.
  • Missing referral from the primary doctor in case of specialist visit while documenting your patient's record can lead to delays in reimbursements from the payer. Thus each and every detail is documented by BillingParadise.
  • Patients who fall under COBRA plan for insurance, have to pay the policy principle every month in order to maintain their coverage. BillingParadise keeps the doctor updated about such patient's coverage and informs the patients if required by the client.
  • BillingParadise checks whether the patient has denied history of claims due to lack of progress in recovery.
  • BillingParadise checks whether the healthcare coverage is limited only for specific or regional area.

No one likes surprises, neither your patients from you nor you from the insurance carriers. So BillingParadise ensures that you claims are never again denied due to a shoddy, unprofessional or hurried insurance verification process.

Delivering 100s of eligibility checks a day! Talk to us to know more.

Specialty Focused RCM Services

We have specialized teams of medical billers and coders who hold speciality specific certifications to handle your billing and coding tasks

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BillingParadise employs trained personnel to manage your claim denials. All claim reworks are done in the fastest way and are always inspected by our in house quality auditors before resubmission.

Foolproof System

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At BillingParadise we have designed our Denial Management Operation workflow to be streamlined and highly productive. We ensure that your denials are reworked correctly and on time.

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BillingParadise provides you the most optimized and cost effective software.The DenialBridge is a turnkey software solution. Easily deployable, seamlessly scalable & can be maintained & updated.

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