Eligibility Verification

Streamlined Pre-Certification & Insurance Verification Services

Pre-certification and insurance verification can be complex. Our team ensures timely, accurate verification, avoiding care delays and securing approvals. Focus on patient care while we handle the paperwork, streamlining your operations.

Eligibility Verification

Insurance Eligibility Verifications and Pre-Authorizations

Verifying eligibility and obtaining prior authorizations are vital in the medical billing process. Neglecting these can lead to delayed payments and denials, impacting your revenue. Prompt eligibility checks provide clear insights into patient coverage and payment obligations, streamlining claim submissions and reducing rejections.

At PromedCL, we specialize in insurance eligibility verification and have over 17 years of experience in medical billing and coding services. Our solutions optimize your revenue cycle and enhance collections.

If your team is overwhelmed with insurance verification tasks, outsourcing to us is an ideal solution. Benefit from our expertise to strengthen your eligibility verification process efficiently.

Pre-Authorization Services

reducing rejections

As part of our Pre-Authorization services, we assist in obtaining prior approval from insurance carriers to ensure timely payments and reduce the risk of claim denials. Our medical billing team handles the entire Pre-Authorization process for healthcare organizations, relieving the workload for your front desk staff. Our specialists can assist you with:

Contacting the respective care management department for approving pre-authorization.
Place the request on behalf of the client
Explain the Medical necessity
Obtain the Prior authorization within a quick turnaround time
Report the approved and denied authorization information prior to the patient’s schedule.

Insurance Eligibility Verification Services

Insurance verification is an important first step when a patient schedules an appointment. This process helps prevent claim denials and supports smoother revenue flow. At PromedCL, we provide real-time verification of patients’ health insurance as part of our clinical data management services. Our team works closely with patients, healthcare providers, and insurance companies to confirm coverage and ensure all necessary details are verified before treatment. This helps avoid surprises and ensures that everything is in order before care is provided.

Our Medical Credentialing Process

Insurance Eligibility Verification Services we Offer

Our team incorporates the most skilled and talented insurance specialists who can cater to Insurance eligibility verifications and pre-authorizations needs. Some of the Pre-certification & Insurance Verification offerings included

Health Insurance Document Checking

On receiving necessary documents from your healthcare organization, we carefully analyze all the documents & verify them before the scheduled appointment. On checking all the relevant documents, we compile the paperwork & arrange them sequentially as demanded by the insurance company.

Verification of Insurance Verification

Our medical billing experts verify insurance E&B and insurance coverage details with primary & secondary payers. We take necessary details such as co-insurance, copay, deductible, PCP name matching, in-network, and out-of-network benefits, and update these details in the patient notes.

Patient Follow-Up

As a part of our service procedure check, for any incorrect or missing information required our team actively follow-up with the patients and contacts them to correct or fill in any missing details. This enables us to keep track and verify all relevant information & documents before its final submission.

Final Claim Submission

As a part of our final claim submission, we provide our clients with the final results. This includes required documents & relevant information such as member ID, group ID, insurance coverage dates, copayment (co-pay) information, etc.

Don’t let the red tape stop your pace.

Credentialing can be a hassle, but not with us. We have the expertise, resources, and network to get you credentialed and enrolled with any payer you choose. Regardless of your specialty or location, we’ll help you gain the advantages of being in-network!

Discuss your Insurance Eligibility Verifications and Pre-Authorizations Services Requirements with us

Insurance data security
Cost-effective solutions
Use of latest medical billing technology & software
Quick turnaround time
Accurate verification services
Ease of scalability
Two decades of experience
Expert medical billing team

Planning to outsource insurance eligibility verification to a reliable service provider, then look no further. Get in touch with us at info@promedcl.com today!

Transform Your Revenue Cycle Today

When you create a high-performance revenue cycle, you’re finally free to invest your full resources into what matters most: the care of your patients.

PromedCL Services LLC

1259 El Camino Real
Unit #1125
Menlo Park
CA 940

Call for help:

+1 (877) 420-9099

Mail us for information

Info@promedcl.com