Expert Medical Billing offers a service that will allow your practice to collect this money before patient balances, copays, co-insurances, and deductibles get out offhand. This service that we offer is Eligibility Prior to Service. Insurance eligibility verification prior to service is the first and most vital step in the medical billing process. Insurance verification process is crucial for all encounters, whether inpatient, outpatient or ambulatory care. It will ensure that the hospital/medical office receives payment for services rendered. Eligibility verification is the process of checking a patient’s active coverage with the insurance company and verifying the authenticity of his or her claims.

To avoid claim rejection, the verification process must be done before the patient is
admitted into a hospital, sees a physician or gets services from a medical professional.

Eligibility Prior to Service includes:

  • Verifying eligibility through insurance portals ‘identify the patients with lapse of coverage.’
  • It will also give us a clear view on patients benefits and copay, which helps our front desk collect at the time of visit, even when there is not a copay mentioned on the card.
  • Patient’s balance is kept up to the date, so that patients will know they responsibility at the time of service.
  • If patients have any disagreements on their balance, the patient can request the front desk for call back from our billing team.
  • We will make sure that charges are submitted within 48 hours after the service being performed, which keeps our revenue healthy.
  • We are not like other billing company who work on denials after it was denied by the insurance company, instead we scrub all claims at the time of entering charge and will do required correction before submitting to insurance.
  • We will also do a monthly auditing on charge entry. Once we received a denial from insurance, we give high priority for claims with high dollar value and the insurance with less timely filing limit.
  • Denials will be addressed within 4-5 days, including appeals and redetermination requests.
  • Our AR analytics team will work on those denial claims and will solve 60-70% of the denials before they forward to our AR Calling team.
  • Because of our hard work ahead of time your denials will decrease significantly, and your practice will collect more of it’s money upfront from patients and in a better timely manner from insurance companies.


Want more information on our Eligibility Prior to Service? Email us today for more information on how we can best assist your business: [email protected]