Medical Billing Expert

Insurance Eligibility Verification Made Accurate and Fast

Reduce Ineligibility, Improve Cash Flow

Insurance Eligibility Verification Services

If you are looking for new ways to revamp your RCM model to remain competitive, you need to focus on one of the front-line components of a well-oiled revenue cycle management process - insurance eligibility verification services. MedBillingExperts has over 10 years of experience in helping healthcare practices reduce their accounts receivable cycle and increase revenue. Our dedicated team of experts provide supreme healthcare insurance verification services to insulate you from costly write-offs and denials, our superior process workflow reduces your time to generate clean claims.

The insurance eligibility verification services by MedBillingExperts is driven by a skilled team with wide experience in handling the end-to-end requirements of insurance verification, and a well-defined process to confirm coverage and benefits from different sources - integrated eligibility inquiry to individual payer websites - for accuracy of claims submission and highest degree of patient and provider satisfaction. We provide healthcare insurance eligibility verification services and our clients leverage our expertise to standardize admission process and guarantee faster turn around times.

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We Provide Detailed Insurance Verification Services. Here's How:

  • Verify patient information that includes payable benefits, deductibles, claims mailing address, patient policy status and plan exclusions.
  • Obtain pre-certification number and obtain approval for the authorization request and co-ordinate with the client for further details.
  • Verify patients' coverage on all primary and secondary payers and updating the patients accounts on time.
  • Maintain highest levels of accuracy and maintain communication with the client till the completion of paperwork.
  • Verify the co-pays, co-insurances, deductibles and claims mailing addresses for seamless process.

Our End-to-End Insurance Eligibility Verification Process

Patient Registration

Our insurance eligibility verification process starts from the moment the patient is admitted to obtain medical treatment

Insurance Eligibility Verification

With this step we verify the eligibility criteria of patients and whether the patient has appropriate insurance coverage

Auditing Quality Check

Evaluate for errors and inconsistencies prior to submissions. We contact the insurance companies to obtain approval for authorization request


Thorough follow up on the patient accounts to receive the claims reimbursements, appeals, or any missing information for billing

Insurance Eligibility Verification Services We Specialize In

Document Checking

As one of the leading insurance verification services companies, we follow a systematic approach. It begins with collecting the information needed to work on an invoice. The dedicated team takes measures to maintain the highest levels of accuracy when you choose to outsource insurance eligibility verification services. The documents received are analysed and verified against the list of the necessary documents. This step ensures that the documents are properly authenticated based on the needs of the insurance companies.

Insurance Verification Services Companies
Verifying Patient's Insurance Coverage

Verifying Patient's Insurance Coverage

We check and validate the coverage details of individual patients. We are one of the most reliable insurance verification services companies in USA. Our team determines coverage by checking the insurance carrier's website and makes note of the effective date of the policy, the procedures, diagnosis and services that are deemed covered under the policy and the limitations and exclusions of the policy.

Patient Follow-up

Our healthcare insurance eligibility verification services opt different modes of communication to promptly contact the patient and collect details about any missed or erroneous information. Once you choose to outsource insurance eligibility verification services, we keep tab on the information and verify the same at regular intervals. On listing the benefits and outlining the policy limitations, our team follows-up with patients ensuring that they understand the financial aspects when they undergo medical procedures.

Patient Follow-up
Insurance Denial Appeal

Insurance Denial Appeal

MedbillingExperts is one of the reliable insurance verification companies with a dedicated team of data experts validate accounts receivable and insurance claims for maximum reimbursements. We also monitor details of the co-pay information and look for diagnostic data to ascertain if the procedure is medically necessary. Besides, every denied health insurance claim is appealed immediately to reverse the denial and get full reimbursement.

Final Submission

Our final submission report of insurance verification services covers complete benefit breakdown along with other vital details related to member ID, group ID, start and end dates of the insurance coverage. The final report will contain any pre-authorizations that may need to be obtained to ensure that insurance coverage is relevant to facilitate complete claims reimbursements.

insurance verification services
Business Process Improvements

Identifying Business Process Improvements

As one of the most trusted insurance verification services companies, the objective is streamlined billing and verification process. Our experts work precisely and identify discrepancies with the data to resolve the problem right from where it stems. We ensure that we meet market demands, achieve customer satisfaction and faster turnaround times. Besides, our insurance verification services assist our clients to leverage process workflow and generate clean claims.

Sorting Insurance Verification into Categories

Our dedicated team that provides impeccable insurance verification services, is up-to-date with the regulatory norms. Once, you choose to outsource insurance eligibility verification services, we work on categorising them. Categorization helps to discover opportunities to adjust workflows and revise existing processes. Once the healthcare insurance verification services are divided into categories, it is easier to re-train experts, employees and providers. This allows us to identify categories with challenges and work at restructuring them for increased number of clean claims. We also conduct regular audits to augment assurance processes and guarantee that the problems are resolved at the source.

insurance verification services

Our Specialties

Why we are an Industry Authority in insurance eligibility verification services

Full Compliance

We cater to a niche segment by adhering to rigid documentation protocols to meet HIPAA compliance

Assured Data Security

We ensure that we use firewalls and our transmission and communication modes include VPNs, SSLs and encryption techniques

Extensive Training

We provide regular training to help the team get acquainted with new technologies and stay up to date

Rigorous Claims Audits

We undertake regular audits of insurance protocols to analyse the type of errors, so as to not repeat them, thereby streamlining the insurance verification process

High Accuracy

Our expertise in billing and insurance verification services helps clients expediate the revenue cycle management for quick processing of claims

Superior Technology Capabilities

We opt for high-end technology to reduce costs, generate new leads and attain higher levels of accuracy and diligence in our service

How We Help You Streamline Insurance Eligibility Verification

Patient eligibility verification

Our dedicated team of experts collate patient information and verify the same to ensure that the data is accurate and free of errors

Obtain authorization

We ensure that effective pre-authorization is carried out seamlessly to ensure seamless processing

Contact patients

We communicate with patients for additional information necessary to process the application

Read What Our Clients Have to Say About Us

Dummy Name Dummy Location

"Our decision to outsource insurance eligibility verification services to MedBillingExperts helped us tackle the delays in reimbursements. As a key step in medical billing and coding, they took care of the verification and pre authorization processes effortlessly. The team understood the complexities involved in insurance claim reimbursements and provided us accurate patient verification and flexible solutions to suit our requirement. Thanks to the team, we have streamlined the insurance verification process and we now focus more on our core competencies."

Dummy Name Dummy Location

"The many steps involved in claims verification services can slow down your business. But when you choose to outsource insurance eligibility verification services, you get better turnarounds. We choose MedBillingExperts as we had read reviews online and our decision has helped streamline our revenue cycle. The dedicated billing and medical coding team has gone the extra mile to pre-authorize and validate the patient information and give clear and concise data- a requisite to prevent delays and denials. This reaffirmed our faith in a well-acclaimed brand that stands for diligence and has years of experience in offering insurance verification services to global clients".

Insurance Eligibility Verification Management
Through Our lens

Medical Insurance Eligibility Verification Process

Our Process

Medical Insurance Eligibility Verification Process

We have an elaborate and precision-oriented process to help you streamline the insurance eligibility verification process and focus on your business. Go through the diagram to understand how our insurance verification service works.

How It Works
Medical Insurance Verification Partner


How to Choose the Right Medical Insurance Verification Partner

Choosing the right medical insurance verification partner is important as it directly impacts the revenue cycle. The most suitable partner for insurance verification process can augment turnaround times. Get higher reimbursements and keep your focus on the business while insurance eligibility verification is done by a professional team.

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Meeting eligibility benefits and verification challeng

Case Study

Meeting eligibility benefits and verification challenge

The client is a Minnesota based medical billing company working with over 100 clients across multiple specialities. The client wanted to establish a streamlined eligibility verification process. Based on the client's requests, we implemented multi-pronged strategy to streamline client's insurance eligibility.

Read our Case Study
Claim rejections and denials


Steps to avoid claim rejections

Claim rejections and denials are a result of minor errors. The article explores the impact of errors like erroneous demographic data, incorrect codes and more. The article delves into the various steps that can streamline revenue cycle and explores measures to rectify them.

Our Articles

FAQ's on Insurance Eligibility Verification

Insurance verification is the process of contacting the insurance company to determine whether a patient's medical insurance coverage and health benefits cover the required procedures and treatments or not. Some of the information that the healthcare provider requires includes demographic data, policy limitations, benefits or co-pays involved, coverage and deductibles, and restrictions and prior authorization for treatments from the appropriate sources. Insurance verification is critical in revenue cycle management, as without adequate coverage, medical services may be provided, but never paid for. Insurance verification is key to determining how much money is owed for each type of service provided, as well as which individual or entity is responsible for paying it off.

The cost will vary according to the scope and complexity of the work. We can fix a price either per FTE or per transaction. The more time it takes to complete a transaction, the higher the cost. Additionally, we can also provide a 1-week trial period without any costs involved, upon which we can mutually agree on the pricing.

Healthcare insurance verification results in better cashflow as claims are quickly processed and accepted, thus eliminating write-offs and claims denials. Also, if the eligibility verification process is smooth, eligibility responses can be concisely and consistently viewed. This means that the eligibility verification results are attained more efficiently, leading to fewer denials and misallocation of resources. Finally, outsourcing healthcare insurance verification results in faster billing cycles because of reduced payment delays that are caused by claims denials.

Insurance verification should ideally be conducted prior to the patient visiting the medical care facility for treatment or medical procedures. This way, the healthcare provider and the patient are both aware of their financial responsibilities and whether coverage is in fact in place for the treatment. Without proper insurance verification and coverage, all medical claims may be denied, and payment must come out of the patient’s pockets.

Some reasons for claims rejections post insurance verification include inactive patient coverage, changed insurance plans or providers, medical services covered are non-covered benefits, patient insurance involves out-of-network coverage, or the medical services provided needed pre-authorization.

All eligibility checks are made through a variety of ways. Eligibility checks made over the phone require that our experts only speak to human representatives because automated systems do not always provide reliable or complete patient information. Checking the insurance carrier’s website is another way to determine coverage. Finally, some clearinghouses and practice management systems are capable of verifying patient eligibility on your behalf as well.

There are many medical insurance verification software in the market that can deliver results instantaneously (in real-time) or take just a few seconds depending on which software you choose to use. Alternatively, detailed insurance verifications by phone will take approximately 30 minutes.

Insurance verification is usually triggered when medical services or procedures are required during a hospital or healthcare practice visit. Medical insurance verification can obtain critical patient information from the number of visits left to the deductible amounts involved. Ideally, insurance benefits should be verified at least once a year, particularly when the insurance plan changes or is due for renewal.

Our experts access online verification portals or call the insurer to get the necessary patient information to put in a medical claim. Our team verifies benefits and procedure-specific coverage and also obtains all the required referrals and authorizations. Some of the details we ensure that we verify include payable benefits, deductibles, type of plan, and effective dates. We also check the co-insurance, coverage details, patient policy status, plan exclusions, DME reimbursements, out-of-network benefits, and health insurance caps involved.

FAQs on Outsource Verification Services


Clean Claims On First Submission




HIPAA Compliance


Increase in Collections

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