Eligibility Verification Service
At CREDENSE, we believe that the verification of insurance benefits is a critical component in ensuring an efficient and effective healthcare system. With our expert guidance, we strive to standardize admission processes, thereby enhancing the patient flow and reducing administrative and financial errors. The process of insurance eligibility verification has evolved significantly over the years. It's no longer a simple check of deductibles and co-pays. In fact, it has become a multifaceted process that requires an experienced staff who understands the intricacies of payer benefit systems. Our team of experts works with you directly to ensure that all necessary documentation is properly completed for a thorough utilization review. The behavioral healthcare industry is facing challenges as insurance carriers reduce claim payments and add complex criteria to individual benefit plans. Our verification specialists at CREDENSE can help you navigate these challenges and avoid errors, freeing you to provide top- quality care to your patients.
Our verification specialists offer a comprehensive range of services that includes:
- Determining patient policy deductibles and out-of-pocket responsibilities
- Calculating co-insurance and co-payments
- Assessing benefit limits
- Providing reimbursement estimates
- Facilitating pre-authorization and clinical requirements for admissions.
Eliminate Errors and Speed Up Turnaround Times
At CREDENSE, we understand that timely and accurate verification and eligibility of benefits are crucial to improving admissions and maintaining a competitive edge in the healthcare industry. With our years of clinical experience, we have developed a verification of benefits process that sets us apart from other billing companies.
Our approach begins with providing each client with a customized insurance verification form that is designed to capture all necessary information and eliminate the potential for errors. Once you provide us with patient and insurance information, our verification team promptly confirms the benefits by utilizing online portals and making phone calls to ensure accuracy. We take pride in our ability to provide fast turnaround times and typically return completed verifications to our clients in as little as one hour.
Continuous Evaluation of Clinical Reviews
Before providing any advice, it is crucial to verify all benefit information thoroughly. As important as verifying the information at the beginning, it is crucial to make sure that there are no changes to a client's benefits during their stay.
To ensure the accuracy and consistency of benefits information, we conduct continuous clinical reviews of insurance carriers of your client while they are with you. This process helps to avoid the potential risks of errors and ensures that the information you received initially remains up-to-date. We assist your team in planning and identifying any potential changes to each patient's benefits, which strengthens your verification process and allows us to provide the utmost level of service. With our support, you can extend the length of client stays while keeping the insurance provider accountable.
CREDENSE is a company that prioritizes customer satisfaction. Our services are designed to provide the greatest financial return for your organization while being transparent, dependable, and responsive to your needs. Our ultimate goal is to improve the efficiency and effectiveness of your organization. Unlike other companies, we do not push additional products on you. Our exclusive focus is on revenue cycle management to ensure that your organization collects the maximum revenue possible. A significant number of our clients who transitioned to us from other billing companies were discontented with the subpar services they had been receiving. CREDENSE ensures that all our clients receive top-quality medical billing and A/R follow-up services, allowing them to concentrate on their core business.