Eligibility verification​

Delays or denials in medical claims are often the by-products of inaccurate or incomplete insurance information provided by patients or missed out by administrative staff. Determining insurance eligibility directly impacts a provider’s reimbursement. Failing to verify a patient’s coverage often leads to payment delays, claim rejections, non-payment, and decreased patient satisfaction.

QWay Healthcare’s eligibility verification process thoroughly checks all essential patient insurance details, including effective dates, plan exclusions, benefits, coverage specifics, co-pays, co-insurance, and pre-authorization numbers. We also cross-verify patient information against insurer records to ensure complete accuracy before claim submission.

The documents received are thoroughly analyzed and verified as state by the insurers.

A day before to the scheduled patient visit patient's insurance E&B; and insurance coverage data is verified with the primary and secondary payers.

Co-pay, deductible, co-insurance, in-network and out-of-network benefits, and PCP name matching are then recorded and updated in the patient notes.

A follow-up encounter with the patient is done to seek any missing or incorrect information and get the required authorization.

The client is provided with final information about the patient’s eligibility coverage and other details.

More Why Choose Us

Reduced A/R Days.

Data security with latest technology driven solutions

Clearer & Cleaner data on the billing system.

Low Co-Pay, Registration & billing errors.

Reduced billing & Collections cost.

Control bad debts & Improve patient satisfaction.

Aid a more effective patient financial counselling program.

Accelerate reimbursement & eradicate Rework.