Eligibility & Benefits Verification Features

Appointment Confirmation

  • Confirm appointment one business day in advance.
  • Conducted during normal business hours.
  • Contact patient via phone and /or SMS.
  • Update EMR/ PMS when patients reply.
  • Reschedule appointment when necessary.
  • Send personalized text messages as may be requested by practices.
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Eligibility & Benefits Verification

Patient Demographic Validation

  • Confirm eligibility and benefits three business days in advance.
  • Obtain new or replacement insurance carrier from patient.
  • Update EMR/ PMS with new insurance carrier information, policy, or both.

Coverage Validation

  • Benefits Validation.
    • Determine copays.
    • Determine deductible (met or unmet).
    • Determine coinsurance.
  • Update billing software.
  • Communicate to practice via EMR / scheduler notes.
  • Advise reception of the actual amount to be collected from the patient at time of check-in. (i.e., past due balances plus any co-pays and deductibles.)
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Miscellaneous

  • EMR/ PMS ownership lies with the Practice.
  • All additional third-party payments to be billed as per actual, such as clearing house charges, patient statement vendor, etc.
  • Physician has access to a dedicated Account Manager at Billing Advisors (By Phone) 24 hours & 7 days a week.
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Pricing

 The Fee for Service is pre-paid. It is based the average number of patients seen per day. The rate is then multiplied by the number of staff corresponding to the number of appointments then multiplied by an 8 hour day, then multiplied by a 5 day work week, then multiplied by 52 weeks in a year, then divided 12 months in a year. This will become the monthly amount due.

 The invoice is issued on the 16th of each month. It is due upon receipt.