Financial Clearance/Insurance Verification & Eligibility

Verifying benefits and coverage is a vital part of the medical billing process to secure Payment and avoid denials. A lot of times patients provide outdated health insurance information and practices find it difficult to determine whether the patient is eligible for benefits without verifying with the payer.

Bikham Healthcare ensures to check the insurance eligibility and benefits through Online as well as Phone with the insurance company regarding any payment responsibility that the patient needs to fulfill prior or post the treatment.

  • We would be able to provide benefits and eligibility verification almost in real-time.
  • We would access the patient demographic through Fax, FTP, and Practice Management System and call the payers for Patient coverage, Benefits, Pre-certs and any authorization in case of any emergencies.
  • We would also assess the reimbursement contract review depending upon the client requirement.
  • If We Identify any types of Coverage issues prior to patient treatment, we would update the practice so that they would discuss the payment options with the patients at the time of appointment.

The details that the Bikham team verifies include:

  • Effective date and coverage details
  • Type of plan
  • Payable benefits
  • Co-pay
  • Deductibles
  • Co-insurance
  • Claims mailing address
  • Referrals & pre-authorizations
  • Pre-existing clause
  • Life time maximum
  • Other related information

This information is collected and verified before the patient appointment date as it helps in getting referrals, prior authorization numbers, and optimizing the billing process, as well as preventing denials due to invalid benefits and eligibility reasons.

Once the verification process is completed and the patient visits the healthcare provider, treatments are generated.