Verification of Benefits

Effective Eligibility Verification of Benefits is essential for healthcare providers to efficiently and accurately receive necessary information about a patient’s insurance coverage. The decisions made about a patient’s care, prescriptions, and further diagnostics, particularly in elective and non-emergency procedures, are based on their eligibility. Inadequate checks and balances in the eligibility verification process can result in significant revenue losses due to claim denials and delayed payments.

Insights gained from patient eligibility at the front end of the process enable healthcare providers to recommend appropriate treatment aligned with the scope of coverage, classification of out-of-network benefits, and payment obligations.

Our skilled team handles the eligibility verification process for patients, utilizing their expertise in confirming coverage and benefits from individual payer websites and making phone calls. We guarantee our clients a standardized admission and eligibility verification process and quick turnaround time.

Optimize your revenue cycle and improve your collections by utilizing Blazevue Healthcare’s exceptional Eligibility Verification services.

Authorization

Authorization in medical billing is the process in which the payer grants approval to cover the prescribed medical services before they are provided. This process is also referred to as pre-authorization or prior authorization services.

In the authorization process, the medical biller and healthcare provider work collaboratively to obtain approval for medical services. The medical coder is responsible for assigning the correct CPT code to the medical procedure received by the patient. It is essential for the medical coder to assign the appropriate CPT code to avoid claim denial.

The responsibility for obtaining authorization for the medical procedure falls on the healthcare provider. The provider must apply for authorization before performing the procedure. Once approved, the payer provides the healthcare provider with an authorization number for future reference.

Our team of highly-trained experts is equipped with in-depth knowledge to manage all the paperwork and obtain request approvals from insurance companies quickly and efficiently. As a top prior authorization company, we are dedicated to providing reliable and timely services to our clients. Contact one of our experts today to learn more about outsourcing your Medicare prior authorization needs.