Eligibility and benefits verification is an essential step in medical billing, as it ensures that healthcare providers are reimbursed accurately and in a timely manner. Here are some of the reasons why eligibility and benefits verification is important:

  • Accurate patient information: By verifying patient eligibility and benefits, healthcare providers can ensure that they have accurate patient information, such as insurance coverage and co-pay requirements. This helps to prevent billing errors and reduces the likelihood of claim denials.
  • Timely reimbursement: Verifying patient eligibility and benefits before providing services helps to ensure that claims are submitted accurately and on time, which helps to speed up the reimbursement process.
  • Reduced claim denials: By verifying patient eligibility and benefits, healthcare providers can reduce the likelihood of claim denials due to incorrect or outdated patient information.
  • Faster reimbursement: By verifying patient eligibility and benefits before providing services, healthcare providers can submit claims more quickly and accurately, which can speed up the reimbursement process.
  • Improved cash flow: Insurance verification can help healthcare providers to receive accurate and timely reimbursements, which can improve cash flow and financial stability.
  • Improved patient satisfaction: Accurate verification of eligibility and benefits can help to prevent surprises for patients, such as unexpected bills or denied claims, which can improve patient satisfaction.

How HSR Billing Solutions will do it?

  • HSR billing professionals access the patient’s information from the face-sheet or from the file received from the provider/facility in a secure email.
  • Based on the insurance, team will verify eligibility and benefits through websites, IVR and by calling the provider line of the insurance.
  • The information collected will be entered in the patient’s account in a formatted note.

If there is no coverage for the patient, there is another team who does patient calling. Patient is called and informed about the same and is asked for alternative insurance information.