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ELIGIBILITY VERIFICATION

Insurance eligibility is a crucial and indispensable step in the medical billing process which in turn directly affects the reimbursement of a practice. Overlooking the process of process of verifying the patient’s eligibility with the insurance invariably leads to delays in payments, non-payment of claims, rejections, and unhappy patients.

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    Clean Claims for Cash-flow

    It is imperative at the preliminary stage of the revenue cycle management process to fix the Authorization and verification step, in order for a seamless flow of reimbursement. QWay Health’s eligibility verification process will verify the information that is relative to the patient’s screening process.

    Our process clearly identifies:

    • Effective dates
    • Plan exclusions
    • Benefits
    • Coverage details
    • Co-pays and details of Co- Insurance
    • Pre- Auth Number
    • Patient Details as against details with the Insurance

    Spotting gaps and errors in information are the first steps we take to get you up and running on the claims process. Eliminate uncollectable revenue with our highly effective Eligibility verification process.

    • Reduced A/R Days.
    • Clearer & Cleaner data on the billing system.
    • Low Co-Pay, Registration & billing errors.
    • Reduced billing & Collections cost.
    • Control bad debts & Improve patient satisfaction.
    • Aid a more effective patient financial counselling program.
    • Accelerate reimbursement & eradicate Rework.
    Spotting

    PATIENT DEMOGRAPHICS ENTRY SERVICES FROM QWAY WILL CAPTURE

    PATIENT DETAILS

    Patient name and ID#, Gender, Marital Status, Email, Date of Birth, Social Security Number, Contact numbers work and home and Address work and home.

    GUARANTOR / ACCOUNT DETAILS

    Guarantor Name, Date of Birth, Work and Home Phone and Address details.

    INSURANCE DETAILS

    Insurance Identification Number, Name and address of the Insurance company, Group name/ group number, Details of the policy and policy effective date and termination, policy number, Name of the insured, Date of Birth and the relationship of the insured to the patient.

    frequently asked questions

    • 1. What is verification of eligibility?

      Eligibility verification is a process of checking a patients’ eligibility coverage with the insurance company and verifying the authenticity of their claims.

    • 2. What is dependent eligibility verification?

      Dependent Eligibility Verification (DEV) is the process of verifying the eligibility of dependents enrolled in state health and dental benefits. Healthcare professionals must verify the eligibility of all the dependents prior to enrolling them in a health plan.

    • 3. What are the 2 purposes of the insurance verification process?

      A. Minimizes Claim Rejections and Denials.
      B. It helps in verifying the insurance coverage in advance, for procedures or equipment, and results in fewer claims being denied.

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    HIPAA
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    ISO 9001:2015 & ISO/IEC 27001:2013
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    HEALTHCARE BILLING
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    RBMA CORPORATE PARTNER