Eligibility & Authorization
Verify Before You Serve. Get
Paid Every Time.
Comprehensive eligibility verification and prior authorization management that prevents denials at the front door.
Get Started
Our Approach
Stop Denials Before They Start
Eligibility issues and missing authorizations are among the top reasons for claim denials in healthcare. Our front-end team verifies patient insurance eligibility, benefits, and coverage details before every encounter. For services requiring prior authorization, we manage the entire process — from initial request through approval — ensuring nothing falls through the cracks.
What You Get
Your Goals, Clearly Delivered
Denial Prevention
Catching eligibility issues before the encounter eliminates the #1 cause of preventable claim denials.
Authorization Success
Proactive prior authorization management ensures approvals are in place before services are rendered.
Patient Transparency
Verified benefits allow you to communicate patient financial responsibility upfront, improving collections.
Workflow Efficiency
Automated eligibility checks and authorization tracking reduce staff burden and phone time.
Our Process
From Verification to Approval
Eligibility Check
Insurance coverage, benefits, and active status are verified for every scheduled patient.
Benefit Analysis
Deductibles, copays, coinsurance, and coverage limits are documented for accurate billing.
Auth Request
Prior authorization requests are submitted with required clinical documentation.
Status Tracking
Authorization statuses are tracked and updated, with alerts for expirations and renewals.
Why It Works
Measurable Impact, Every Time
- Denial Prevention: Catching eligibility issues before the encounter eliminates the #1 cause of preventable claim denials.
- Authorization Success: Proactive prior authorization management ensures approvals are in place before services are rendered.
- Patient Transparency: Verified benefits allow you to communicate patient financial responsibility upfront, improving collections.
Results
What Our Clients Achieve
99%
Verification Accuracy
92%
Auth Approval Rate
50%
Reduction in Eligibility Denials
Same Day
Verification Turnaround
FAQs
Frequently Asked Questions
Are Eligibility Errors Costing You Revenue?
Get a comprehensive eligibility & authorization audit — denial root-cause analysis, verification workflow review, authorization tracking benchmarks, and revenue recovery opportunities.