RP Sanjiv Goenka Group

Eligibility and Benefits Verification Services

Approve Claims Without Hassle or Delay

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

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:

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.

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.

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.

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 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 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.

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.

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.

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.

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.

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Eddie Monteiro

Eddie is currently Chief Operating Officer at Educational Testing Service (ETS), where he sets and drives the transformation agenda across the company and has responsibility for all technology and operations functions in addition to the College Board, K-12, and teacher licensure businesses. He previously ran business and technology services at Pearson, where he built a global team to enable scalable delivery of enterprise functions. Prior to that, while at IBM, he held several executive leadership roles in the US, Mexico and Brazil across a diverse set of industries and clients.
Geetha Krishnan

Geetha Krishnan

Geetha Krishnan consults with the Indian Institute for Human Settlements in Bangalore as Senior Advisor and Head of Digital Blended Learning, where he spearheads their online learning and continuing education portfolio. Over 25 years, Geetha has played senior roles in diverse sectors such as academia, online learning, and advertising. In his last role as Director – Centre for Executive Education at the Indian School of Business (ISB), Geetha was head of the profit center comprising more than 50 open enrollment and long duration programs and spearheaded ISB’s foray into online learning by enabling their partnership with Coursera.
Susan Aldridge

Susan Aldridge

Dr. Aldridge is an Executive Higher Education Consultant to university presidents and ministers of education regarding business models and technology-enhanced education. She recently retired from Drexel University after serving six years as president of Drexel University Online overseeing more than 125 online programs. During her six-year tenure as President of University of Maryland Global Campus (UMGC), she doubled the university’s enrollment to 97,000 – to become the largest public American university. She also served as Vice Chancellor for Troy University’s Global Campus managing online programs and satellite campuses in 12 countries and 17 states.

Alan Greenberg

Alan Greenberg

Previously Director Apple Education EMEA and APAC, Alan led the team that built Education Podcasting and iTunes U. He has worked on the development of Apple Education mobile strategy, iOS Education APPs, and developed the SEED CSR project in China, a collaboration between Apple, Foxconn, and Pearson. Executive Board of WideCells Group Plc, Group CBDO, and EVP & Founder of Wideacademy; his working contributions include multiple technology engagements providing domain expertise across digital, mobile, brand, scale-up, international business development, and venture capital.

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