INSURANCE VERIFICATION &
ELIGIBILITY CHECK /
FINANCIAL CLEARANCE
Atom Healthcare’s patient registration services involve collecting patient demographic information, insurance/payer information, and other details to reduce claim denials. Our team captures the following information with the highest quality and within the turnaround time:
- Access to qualified charge entry professionals with expertise in working across different medical specialties
- Cost reduction by 30-40%
- Improved productivity, accuracy, and turnaround
- Revenue leakage prevention by identifying missed revenue opportunities through our charge integrity and audit services
- Timely claim filing, benchmarking fee schedules, and understanding denial trends
- Effective coordination with the medical coding team to ensure accuracy
The process for insurance verification and eligibility check (financial clearance outsourcing) involves:
- Receipt of work queues to be processed through the provider’s patient scheduling system, faxes, or via .csv/.txt files through FTP.
- Verification of plan type, primary and secondary coverage details, including member ID, group ID, coverage period, co-pay, claim mailing address, referrals and prior authorization, pre-existing clauses, deductible/co-insurance information, and benefit information.
- Determination of pre-certification or authorization requirements and identification of appropriate channels (calls/web) to connect with the payer to obtain the necessary information.
Our timely performance of insurance verification, eligibility check, and financial clearance information helps minimize claim rejections and denials, improve first-pass rates, avoid claims resubmission, reduce demographic and eligibility rejections and denials, clearly determine patient responsibility, propose payment plans, increase self-pay collections, and enhance patient satisfaction.
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