United Medical Billing Service

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Eligibility Services

UMBS prioritizes thorough eligibility verifications to minimize claim denials and ensure prompt payments.

Insurance Eligibility Verification Services

The crucial stage in medical billing and coding involves verifying insurance eligibility. Ensuring accurate and timely information about insurance coverage and reimbursement is vital. Without proper checks and balances, a healthcare organization risks financial losses. Failure to validate eligibility and secure prior authorization can lead to delayed payments and denials, ultimately affecting collections and revenues. Delayed reimbursements directly impact the company’s cash flow.

Verify patient insurance coverage & co-pays upfront

Patient Eligibility Verification Process

Insurance Eligibility Verification Process

Optimizing Patient Eligibility Verification With UMBS

Ensuring patient eligibility is a critical step in the medical billing process, determining the right to receive healthcare services based on enrollment in a healthcare plan. Outsource Strategies International (OSI) takes the lead as your trusted insurance verification company, streamlining the process to save you valuable time. Our patient eligibility verification services are tailored for practices of all sizes and medical specialties, serving as a vital component in securing reimbursement and preventing claim denials.

"Reduce expenses with a rules-based engine that automates eligibility verification, eliminating the need for manual processes"

Our Eligibility Verification Service Includes

Coverage Transparency

We provide clear insights into patients’ coverage limits, co-pays, deductibles, and out-of-pocket expenses, both in Dallas, Texas, and all over the USA, enabling informed financial discussions.

Optimized Care Planning

By understanding patient coverage, you can tailor treatment plans to align with patients’ benefits, both in Dallas, Texas, and all over the USA, preventing surprises and ensuring compliance.

Thorough Verification

Our team, based in Dallas, Texas, meticulously verifies patients’ insurance eligibility and benefits, ensuring accurate and up-to-date coverage details all over the USA.

Real-Time Insights

Our technology-driven approach, based in Dallas, Texas, enables real-time verification, ensuring that you have the most up-to-date coverage details at your fingertips all over the USA.

Efficient Claims Processing

Accurate coverage information, both in Dallas, Texas, and all over the USA, translates into streamlined claims processing, reducing the risk of denials due to coverage discrepancies.

Preventive Measures

Early identification of coverage gaps or limitations, both in Dallas, Texas, and all over the USA, allows you to address potential issues proactively, minimizing claim denials and delays.

Minimized Billing Errors

Accurate coverage verification, both in Dallas, Texas, and all over the USA, minimizes billing errors, ensuring that claims are submitted correctly the first time.

Customized Solutions

We adapt our verification process to align with your practice’s workflows, seamlessly integrating with your existing patient management systems.

Thorough Verification

Our team, based in Dallas, Texas, meticulously verifies patients’ insurance eligibility and benefits, ensuring accurate and up-to-date coverage details all over the USA.

Streamlined Real-Time Insurance Eligibility Verification

Real-Time Insurance Eligibility Verification

Enhance your revenue cycle management by allowing us to streamline the real-time eligibility check for patients. Timely identification of patient insurance helps prevent claim denials and ensures an error-free billing process. By verifying insurance details proactively before submitting claims, you can save time, reduce revenue losses, and avoid payment delays resulting from inaccuracies. 

Benefits of Outsourcing Your RCM Billing

Benefits of Outsourcing your RCM Billing to United Medical Billing Solutions are as follows:

"Outsourced Medical Billing Services You Can Trust"

How to

Manage Claims with Patient Eligibility Verification

Ensuring patient eligibility is a pivotal element of effective revenue cycle management. Proactive insurance claim management is equally crucial. Health insurance verification not only saves time but also minimizes claim rejections. Identifying the patient’s insurance status before providing services is key to reducing claim denials. Proactive eligibility verification significantly enhances overall collections and mitigates reimbursement delays. Moreover, real-time checks on patients’ insurance eligibility contribute to the optimization of the medical billing process.

How to Manage Claims with Patient Eligibility Verification
Not performing insurance eligibility verification can lead to delayed or denied payments, increased administrative costs, and patient dissatisfaction. It may also result in claim denials and potential collection issues for patients.

Insurance eligibility and benefits can be verified by collecting patient information, contacting the insurance payer, verifying benefits, determining patient responsibility, and documenting all details. It is also beneficial to utilize electronic verification tools and stay updated on insurance payer policies.

No, authorization requirements vary by insurance company and plan. Some services may require prior authorization, while others may not. It is essential to check with the specific insurance payer to determine if authorization is needed before proceeding with a medical procedure.

The first step in patient eligibility verification is to collect all relevant patient information, including insurance policy details and primary care physician. This information will be used to contact the insurance payer for coverage and benefit verification.

Some insurance payers may offer online eligibility verification tools for healthcare providers to use at no cost. However, it is crucial to ensure the accuracy and reliability of the information obtained through these tools.