Advance Insurance Eligibility Verification Services
Comprehensive advance insurance eligibility verification to confirm patient coverage before services are rendered.
PlusMed Solutions provides comprehensive Advance Insurance Eligibility Verification services to help healthcare providers confirm patient coverage before services are rendered. Our proactive verification process reduces claim denials, improves cash flow, and enhances patient financial transparency by ensuring accurate insurance and benefit information in advance.
Advance Eligibility Verification Services
Accurate eligibility verification is the foundation of a successful revenue cycle. Our dedicated eligibility specialists perform real-time insurance verification to confirm coverage details and payer requirements before patient visits, procedures, or treatments.
Insurance Coverage Verification
We verify patient eligibility with Medicare and Medicare Advantage plans, State Medicaid programs, Commercial and private insurance carriers, and Managed care and specialty payers.
- Active insurance coverage status
- Policy effective and termination dates
- Covered and excluded services
Benefits and Financial Responsibility Verification
We identify patient financial responsibilities to support accurate billing and patient communication.
- Copayments
- Deductibles
- Coinsurance amounts
- Out-of-pocket maximums
Plan Limitations and Coverage Rules
We review insurance plan details to identify visit limits and frequency restrictions, referral requirements, in-network and out-of-network benefits, and service-specific coverage guidelines. Understanding these rules in advance helps prevent unexpected claim denials.
Coordination of Benefits (COB) Verification
For patients with multiple insurance plans, we verify primary and secondary payer sequence, coordination of benefits rules, and correct billing order. Proper COB verification ensures accurate claim submission and timely reimbursement.
Real-Time Eligibility Confirmation
Our team performs eligibility checks using payer portals, clearinghouses, and electronic verification systems to ensure the most current coverage information is available prior to services.
Eligibility Documentation and Reporting
All verified eligibility details are documented and shared with the practice, allowing front-desk and clinical teams to proceed with confidence and clarity.
Key Benefits
Specialties We Support
- Primary Care and Internal Medicine
- Cardiology
- Orthopedics
- Pediatrics
- Behavioral Health and Psychiatry
- Urgent Care
- Physical Therapy and Rehabilitation
- Specialty and Surgical Practices
Why Choose PlusMed Solutions
- Dedicated insurance eligibility specialists
- Expertise with Medicare, Medicaid, and commercial payers
- Real-time and accurate eligibility verification
- HIPAA-compliant and secure workflows
- Scalable solutions for practices of all sizes
Get Started Today
With PlusMed Solutions' Advance Eligibility Verification services, healthcare providers can reduce billing errors, prevent denials, and deliver care with confidence—knowing coverage details are verified in advance.
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