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
By having a 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 Quintessence, 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 Quintessence 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.
Quintessence 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!
Checking the patient’s eligibility and obtaining prior authorization before the patient visit.
Follow-ups for approvals through the payer’s portal.
Verify patient demographic information.
Verify coverage of benefits with the patient’s primary and secondary payers.
Update your practice management system with the approvals and other information received from the payer.
Claim denial appeals where required.
Quintessence specializes in eligibility and benefit verification services, leveraging their expertise and industry knowledge to ensure accurate and efficient verification processes.
By outsourcing to Quintessence, 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.
Quintessence’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 Quintessence eliminates the need for additional staff and infrastructure investments. This results in significant cost savings for your organization.
Quintessence 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.
Quintessence 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.
Quintessence 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 Quintessence, 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.
Quintessence 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.