Insurance & Eligibility Verification
Over 50% of all health care claims are denied because a patient is not eligible for services billed to the insurer. Often, a patient would be ineligible to claim for benefits because the policy has been terminated or modified. Unfortunately Eligibility Verification is one of the most neglected elements in the revenue cycle. Promantra can help practices significantly increase their revenue by reducing the ineligibility.
Numerous problems are created due to lack of proper eligibility and benefit verification. These include delayed payments, increased errors, nonpayment of claims and patient dissatisfaction. To avoid these problems, Promantra provides a remotely hosted solution for Hospitals and Medical Practices. The solution consists of Promantra deploying expert staff that can be accessed via a toll free number working remotely, with an objective of delivering high quality cost effective patient insurance eligibility and related services.
Our Insurance Eligibility Verification Services Include:
- Receiving Schedules from the Hospital (Via FTP, Fax or E-mail)
- Verify coverage on all Primary and Secondary Payers
- Contact patient for additional information if required
- Provide the client with the results which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information and much more.
- Enter and Update patient demographics
Benefits:
- Improve Account Receivable Cycles (reduce Account Receivable Days)
- Increased number of clean claims
- Increase cash collections by reducing write-offs and denials
Ensuring that patients are eligible for services before care is rendered avoids the risk of not getting paid.
