Full-service RCM and patient contact center solutions firm focused on maximizing your operating margin.
Accurate eligibility verification is essential to a high-performing revenue cycle, yet it remains one of the most error-prone processes for healthcare organizations. Experienced eligibility verification partners help streamline these workflows, improve accuracy, and support timely reimbursement.
Global Healthcare Resource manages the eligibility verification process by collecting critical patient benefit information prior to service delivery. Our skilled eligibility verification team performs comprehensive benefit checks to determine the following:
Properly verifying patient eligibility prior to an appointment can prevent claim denials and promote smooth cash flow. To ensure accuracy, Global Healthcare Resource’s insurance eligibility verification services include the following steps:
When you outsource insurance eligibility verification, your administrative team can lighten its workload. As a result, you can benefit from more accurate medical billing, lower operating costs, and more efficient processes.
With more than 25 years of revenue cycle experience, Global provides proven strategies to support accuracy, efficiency, and long term success.
Our rigorous internal training program, Global Academy delivers ongoing, role based training focused on policy interpretation, accuracy, and revenue cycle excellence.
We customize our services to align with your organization’s unique medical billing and insurance verification needs. We don’t believe in “one size fits all.”
Step 1: We discuss your scope of work and current challenges.
Step 2: Global assembles, trains, and manages a team of highly skilled professionals to work on your project only.
Step 3: In an average of 30 days, your team is fully ramped up and operating at your designated benchmarks and KPIs.
Global Healthcare Resource
When you partner with Global Healthcare Resource, our professionals operate as an extension of your team to perform insurance eligibility verification, ensuring you always have staff in place to complete the work accurately and efficiently. When choosing a revenue cycle outsourcing company, consider Global’s expertise in nearly every medical specialty including cardiology, physical therapy, post-acute, rheumatology, and more.
Speak to us about your insurance verification needs today.
Patient eligibility verification is the process of confirming a patient’s insurance coverage and benefits before providing medical services. This crucial step ensures that healthcare providers receive reimbursement for services rendered. It involves checking the patient’s insurance status, coverage limits, and any applicable co-pays or deductibles. By conducting eligibility verification, healthcare organizations can minimize claim denials and streamline the billing process.
Prior authorization is necessary in patient eligibility verification to ensure that specific medical services or procedures are covered by the patient’s insurance plan. This process requires healthcare providers to obtain approval from the insurance company before delivering certain treatments, medications, or tests. Prior authorization helps control healthcare costs, prevents unnecessary procedures, and ensures that patients receive appropriate care based on their insurance benefits.
Global Healthcare Resource ensures HIPAA compliance by implementing strict policies and procedures to protect patient information. This includes conducting regular training for staff on HIPAA regulations, utilizing secure electronic systems for data management, and ensuring that all communications involving patient data are encrypted. Additionally, Global Healthcare Resource performs regular audits and risk assessments to identify and mitigate potential vulnerabilities in their data handling processes.
Global Healthcare Resource verifies a wide range of insurance types, including private health insurance, government programs such as Medicare and Medicaid, and managed care plans. They work with various insurance providers to ensure comprehensive eligibility verification for patients, allowing healthcare organizations to efficiently manage their billing processes and reduce claim denials.
The eligibility verification process typically takes anywhere from a few minutes to a couple of days, depending on the complexity of the patient’s insurance plan and the efficiency of the verification system used. Automated systems can expedite the process, allowing healthcare providers to receive real-time updates on patient eligibility. However, manual verifications may take longer due to the need for additional documentation or communication with insurance companies.
Outsourcing eligibility verification offers several benefits, including:
