Eligibility & Benefit Verification

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Eligibility and Benefit Verification

Eligibility and Benefit Verification

Being a fundamental part of the billing process, insurance eligibility and benefit verification requires thorough care and attention. Research shows that most claim denials or payment delays happen due to incorrect understanding of insurance plan features.

Payors make frequent changes in their policies, fee schedules. It is important to be aware of those changes and reflect the same in the billing software of the practice. Failing to do so might increase claim denials delay in payment.

Our experienced professionals who are fluent with the particulars of the healthcare industry, such verification tasks are performed in a precise and prompt manner.

Advantages of our Insurance Verification service:

• We maintain a consistent and accurate verification process to ensure there are no surprises.
• Patient’s eligibility and benefits are subject to change. We keep the system routinely updated for the same.
• We handle the follow ups and information retrieval from the payor. This prevents claim denials and loss of revenue.
• Up to date patient information in the system smoothens the treatment planning and promotes a better patient experience.
• We keep a tab on procedure specific coverage as well, to make the patient aware of any out-of-pocket costs if to be incurred.

We verify a wide range of information of the policy:

• Effective Date
• Waiting Period
• Patient Coverage Details
• Frequency Vs History
• Deductibles and Co-Pay
• Non-covered Procedures
• Claims Mailing Address & Payor ID
• Pre-Existing Clauses
• Referrals & Pre-Authorization, etc

Working with Astron EHS, you can be assured of an error-free insurance verification process. Witness in increased patient satisfaction and revenue, while minimizing any chances of claim rejections.

More Of Our Services

Our market-leading RCM Services, Dental Billing and Medical Billing Support are quality driven and client-oriented. We cater to your needs with a customized approach; hence you get the best you deserve. Our solutions include:

  • We manage the collected data for every service-availing patient. This data is stored in software to avoid errors and delays

Fee Schedule Maintenance
  • Right from PPO Fee, UCR Fee, HMO/ DMO Fee & Specialty Fee we handle and manage everything with the help of the best professionals in the market.

Credentialing &
  • credentialization is a complicated and time-consuming task which might distract the doctors from their primary job. Hence, we do the needful on your behalf.

  • We handle the following operations and observe each stage of account receivables carefully to make sure the cash-flow is positive and uninterrupted. Claims Status, Paid Amount and EOB, Reason of Denial and EOB, Missing information and resubmission.

  • Astron EHS Services deals with multiple operations to support medical centres, Payment Posting is one of them. We handle your payment flow with the help of innovative technologies like Lockbox and SFTP.
    We deal with scanned EOBs and checks.

Revenue Cycle Management
  • Revenue cycle management (RCM) is an end-to-end financial process in itself. With the help of upgraded dental billing software, Aston EHS keeps a track of each patient care stage, right from registration and scheduling appointments to the final payment of the total dental expenses.