Comprehensive Verification Services
From electronic eligibility clearing to payer escalations, we handle the full financial clearance workflow before the patient is seen.
EDI 270/271 Real-Time Eligibility Clearing
Instant batch and real-time electronic insurance coverage verification directly via clearinghouses and payer gateways.
Prior Authorization & Pre-Certification
Full authorization lifecycle management: reviewing clinical necessity, submitting pre-certs, and tracking approval status before service.
Comprehensive Benefit & Accumulator Analysis
Granular verification of deductibles, co-pays, co-insurance, out-of-pocket maximum accumulators, and policy effective dates.
Proactive Denial Prevention & COB Review
Verification of primary vs. secondary/tertiary Coordination of Benefits (COB) to eliminate "Coverage Terminated" claim denials.
Same-or-Similar & Frequency Limit Checks
Specialized history checks for DME, therapies, and high-dollar procedures to verify payer frequency limits are not exceeded before service.
Direct Payer IVR & Portal Escalations
Manual outreach and portal escalation with commercial and government payers for complex, non-electronic coverage policies.
Add-On Front-Office Support
Patient Scheduling & Intake
Seamlessly bridge financial clearance with practice operations. Our team can also coordinate appointment scheduling directly within your EHR/PM software following successful insurance verification.
Benefits of Professional Verification
Clearinghouse & Payer Portal Integrations
We verify directly inside the gateways your payers use, so eligibility data comes back from the source rather than a cached copy.
SCHEDULE FREE CONSULTATION
Insurance Verification Services
Our insurance verification specialists will analyze your current verification process and provide customized recommendations to reduce denials and improve cash flow. Get expert insights on real-time verification, prior authorization management, and benefit analysis strategies.
Our medical billing consulting group provides the strategic guidance and tactical support needed to optimize billing processes, technology, and staff skills. With our consultancy solutions, every practice is positioned to thrive through improved medical billing.
Ready to Reduce Your Claim Denials?
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