According to RemitData insurance coverage related issues were the one of the top 5 reasons for claim denials. With the cost of reworking on claims steadily going up it is time for orthopedic practices and groups to automate and increase the effectiveness of their insurance eligibility verification processes. Our eligibility verification solution is built form the ground up for orthopedists. It is scalable, highly secure and helps you eliminate frontend bottlenecks.
Through VerifyNow healthcare organizations can instantly access and verify the coverage information of patients. Access over 800 health insurance payer connections to federal and commercial insurance companies in realtime. Yes, we made it simple for orthopedists.
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Schedule an online demo with one of our knowledgeable associates to see how our integration with your EHR can help you automate the patient eligibility verification process. Know More!
BillingParadise helped her find out the weak links in her billing cycle, identify revenue opportunities and boosted her practice center's revenue significantly.
Collect patient payments before they turn into pending AR through our self pay coverage identification solutions.
Quicken pre authorization follow up and reduce eligibility errors
Completely re-engineer your eligibility verification process
At BillingParadise we use a specialty-tailored eligibility verification workflow built for orthopedic practices. Our “VerifyNow” system connects to over 800 payers (federal + commercial) to confirm coverage in real time, checking policy status, plan type, benefits, copays/deductibles, pre-auth requirements, and provider status — all prior to the date of service.
Yes. Our process includes plan benefits checks that surface co-pay/co-insurance, deductible and other patient financial responsibility. This helps ensure you and the patient know what to expect before service, reducing last-minute surprises.
Yes — because our orthopedic patient-eligibility solution is expressly built for orthopedists, we handle complex procedure types. The same robust coverage checks apply regardless of complexity or sub-specialty.
Our verification process does pre-authorization and benefits checks before the date of service. This includes identifying any facility or provider network status issues (e.g. facility network alignment), so you are aware if a patient’s plan may treat ASC differently.
Yes — part of our “insurance data validation” includes checking for coverage limitations, plan exclusions, and whether prior authorization or referral is required. We alert the practice and patient early to avoid denials.
We aim to complete insurance verification before the patient visit or surgery — at the time of scheduling or registration, to avoid front-end bottlenecks or last-minute issues.
While our public pages do not explicitly mention “implant and device coverage,” our eligibility verification includes benefits and coverage limitations — which would encompass plan’s coverage terms. We can verify whether a patient’s plan covers the scheduled procedure; for implants, we recommend also verifying prior authorization/benefit details under that plan.
Our system supports verification of primary and secondary coverage details. We check member/group IDs, insurance status, and coverage data to ensure payer coordination is set up correctly prior to service.
Yes — our team flags pre-authorization needs and facilitates pre-auth follow-up as part of our eligibility verification service. This reduces risk of cancellations or denials due to missing auth.
We combine real-time payer connectivity, automated RPA-driven eligibility verification, and manual expert review to maximize accuracy. This helps catch inactive coverage, mismatches, or benefit issues early, reducing denials.
Yes — we generate eligibility/benefit verification outputs (policy status, coverage details, copay/deductible, pre-auth needs, etc.) that can be integrated into your EHR/PM system for visibility across front-desk, scheduling, and billing workflows.
Yes — BillingParadise uses automation (RPA bots) for bulk and batch eligibility verification to handle large volumes. This ensures scalability even for practices with high surgical throughput.
Yes — our payer connectivity spans federal and commercial insurers, enabling checks across Medicare, commercial, and other major payer categories.
Yes — our eligibility services are designed to integrate with your existing EHR/PM. BillingParadise explicitly supports popular EHRs, and our API and automation tools can interface with your system for seamless workflow.
By verifying coverage, copays, deductibles, and preauth upfront, we reduce claim denials, avoid unexpected patient balances, and enable accurate upfront patient financial liability disclosure. This improves point-of-service collections and reduces post-service payment disputes and bad debt.
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