Streamline Your Healthcare Revenue Cycle with Accurate Eligibility & Benefits Verification
Every denied healthcare claim is more than just an administrative setback — it’s an unjust denial of compensation you’ve earned for your hard work and compassionate care.
At Firstsource, we're committed to fixing this. Our approach transforms eligibility verification from a bottleneck into your strategic advantage, unlocking your true revenue potential.
According to the Centers for Medicare and Medicaid Services (CMS), in 2023, eligibility-related claim denials continue to be a significant obstacle, rates fluctuate between 1% and 60%, with approximately 70% of these denials caused by incorrect or missing patient information.
We've seen firsthand how this statistic translates into delayed payments, cash flow disruptions, the overwhelming yet avoidable administrative burden, the operational bottlenecks, and perhaps most painful, the conversations with frustrated patients questioning your billing practices.
We don't just understand these challenges—we've walked alongside providers to engineer their solution. Your patients deserve seamless care experiences. Your dedicated staff deserves efficient tools. Your organization needs financial stability. We deliver all three through verification solutions that capture every moment that matters in your revenue journey.
Outcomes Delivered
30% reduction
in eligibility-related denials.2X increase
in verification due to automation.31% reduction
in average AR days.50% increase
in time-of-service collections.The Solution? Delivering on outcomes that matter
Our eligibility and benefits verification solutions and services are curated to address your specific revenue cycle challenges and deliver measurable results
Why Choose Firstsource?
- Comprehensive Verification Services: Validate coverage, determine benefits, and confirm primary & secondary payers with precision.
- Real-Time Results: Our ‘human in the loop’ portal and Integrated Payer API solutions enable instant checks, even during urgent care visits.
- Automation with the Latest Tech: Our in-house AI-powered "QuintAna" BOTs verify eligibility and benefits verification in seconds, eliminating human delays.
- Active Follow-Ups: We handle prior authorization follow-ups through payer portals, reducing administrative overhead.
- Data Accuracy: We ensure patient demographic and insurance details are correct before claims submission.
- Managing Residual Denials: Despite our best efforts, residual denials do occur due to payer behavior. We have systems and processes in place to tackle that effectively and recover revenue faster.
Experience the Firstsource Difference
Boost cash flow and reduce days in accounts receivable
Minimize claim rejections and denials
Enhance patient satisfaction through transparent, seamless billing processes
Focus on delivering quality healthcare—let us handle the administrative complexities
Discover QuintAna - our AI-powered BOT, powered by Firstsource relAI, verifies eligibility and benefits verification within seconds. Our hybrid offering (a first-of-its-kind automation solution with a human touch) ensures faster verifications, reduced costs, increased accuracy, and enhanced patient experience.
Let us transform what appears to be a formidable challenge into a powerful strategic advantage, backed by proven ROI.
Healthcare providers have to verify the eligibility and benefits of every patient before the claim is filed. According to the Centers for Medicare and Medicaid Services (CMS), in 2019, the eligibility/benefits denial rates ranged between 1 and 50%. About 75% of these claims were rejected because the person was not eligible for the services rendered.
With inefficient Eligibility and benefit verification services, medical billing companies end up with the following problems.
Delayed payments leading to delayed access to patient care, resulting in low patient satisfaction
Increased claim rejections due to inaccurate or missing patient data
Decreased collections and increased bad debt
Delayed processing time
By having an effective eligibility and prior authorization service partner, healthcare companies can easily put together cleaner claims that can be checked and approved quickly without delays and hassles.
At Firstsource, we understand the significance of accurate and efficient eligibility and benefit verification. Our end-to-end verification services are designed to address these issues and streamline the revenue cycle chain. By partnering with us, healthcare companies can benefit from a comprehensive solution that ensures coverage validity, verifies primary and secondary payer details, determines allowed benefits, and manages factors like co-insurance and deductibles.
Our eligibility portal and verification services offer a cost-effective, time-bound approach to discovering patient eligibility and benefits. With seamless integration into your practice management system, we perform eligibility checks even for urgent care visits, allowing for smoother claim processing.
By choosing Firstsource as your eligibility and benefit verification service partner, you can overcome the challenges associated with inefficient processes. Experience improved cash flow, reduced claim rejections, faster payments, and ultimately, enhanced patient satisfaction. Trust us to handle this critical aspect of revenue cycle management while you focus on delivering quality healthcare to your patients.
Firstsource has also deployed BOTs to automate eligibility and prior authorization services. With QuintAna you can now verify eligibility and prior auth in seconds! You can learn more about QuintAna here!
Our end-to-end eligibility and benefits verification Services includes:
- Checking the patient’s eligibility and obtaining prior authorization before the patient visit.
- Verify patient demographic information.
- Update your practice management system with the approvals and other information received from the payer.
- Follow-ups for approvals through the payer’s portal.
- Verify coverage of benefits with the patient’s primary and secondary payers.
- Claim denial appeals where required.
Top 10 Reasons to Outsource Eligibility and Benefit Verification Services to Firstsource
Firstsource specializes in eligibility and benefit verification services, leveraging their expertise and industry knowledge to ensure accurate and efficient verification processes.
Firstsource’s streamlined verification services expedite the revenue cycle by reducing processing times. This leads to faster payments, improving cash flow for your healthcare organization.
Firstsource offers scalable solutions that can accommodate fluctuations in patient volume. Whether you experience peaks or valleys in patient demand, they can adapt their resources accordingly, ensuring consistent and efficient verification processes.
Firstsource prioritizes patient data security and compliance with privacy regulations. By outsourcing to them, you can be confident that sensitive patient information is protected through robust security measures and adherence to industry standards.
By outsourcing verification services to Firstsource, your healthcare organization can focus on its core competencies, such as delivering quality patient care. Offloading the time-consuming verification tasks allows your staff to dedicate more time and resources to patient needs.
By outsourcing to Firstsource, you can significantly improve claim approval rates. Their thorough verification process reduces the chances of claims being rejected due to inaccurate or missing patient data.
Outsourcing eligibility and benefit verification services to Firstsource eliminates the need for additional staff and infrastructure investments. This results in significant cost savings for your organization.
Firstsource utilizes advanced technology and integrates seamlessly with your practice management system. This integration allows for real-time eligibility checks, even for urgent care visits, enabling smoother claim processing.
With accurate eligibility and benefit verification, patients experience fewer issues related to claim denials or delays. This leads to enhanced patient satisfaction, as they can access timely healthcare services without financial roadblocks.
Firstsource stays up to date with the latest regulations and compliance requirements in the healthcare industry. By partnering with them, you ensure adherence to all relevant guidelines, reducing the risk of compliance violations and associated penalties.