Medical Eligibility Verification Service


Revex Square’s Medical Eligibility Verification ensures accurate insurance details, reduces claim denials, speeds up collections, and enhances patient experience, helping your practice run smoothly and get paid faster with fewer hassles.

How Essential Is Patient Eligibility Verification for Optimal RCM ?

Patient eligibility verification serves as the cornerstone of revenue cycle management, allowing medical practices to assess a patient’s treatment eligibility. This entails a thorough breakdown of insurance coverage, including copays, deductibles, and co-insurance options. Accuracy in this process is paramount, as statistics indicate that 70-75% of claim denials stem from verification errors. Implementing robust verification protocols not only reduces claim denials but also enhances overall revenue capture and patient satisfaction.

Revex Square addresses this challenge by offering comprehensive eligibility verification services tailored to physicians and private practices. Our solutions provide invaluable leverage in the complex realm of medical billing, ensuring streamlined operations and optimal revenue outcomes. With a commitment to accuracy and efficiency, we empower healthcare providers to focus on delivering exceptional patient care while we handle the intricacies of revenue cycle management with precision.

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Take the First Step to Multiply Your Revenue

Let’s turn your business potential into real profit 

    Up to

    $100k

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    Why Choose Us? Revex Square

    Pioneering Affordable,
    All-Inclusive RCM Solutions

    Claim Accuracy
    10 +
    States Served
    10 +
    Happy Clients
    10 +
    Specialties Expert
    10 +

    Work Hours

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    Monday
    9AM - 5PM
    Tuesday
    9AM - 5PM
    Wednesday
    9AM - 5PM
    Thursday
    9AM - 5PM
    Friday
    9AM - 5PM
    Saturday
    1PM - 8PM
    Sunday
    10AM - 4PM
    24*7 Emergency Care Open

    Step-by-Step Guide to Efficient Medical Coding Process

    Step 1

    Document Collection

    Gather complete and authenticated medical records, including physician notes, operative reports, diagnostic results, and ancillary documentation, to initiate the coding process.

    Review & Analysis

    Examine the collected records to interpret clinical details, verify completeness, and ensure documentation accurately reflects the patient encounter.

    Step 2

    Step 3

    Feedback & Suggestions

    Engage with physicians or clinical staff to resolve ambiguities, missing details, or conflicting documentation to ensure coding accuracy and defensibility.

    Step 6

    Code Selection

    Abstract relevant clinical elements and assign appropriate ICD-10-CM, CPT, and HCPCS codes, applying correct modifiers and coding conventions.

    Step 5

    Compliance & QA

    Validate assigned codes against CMS, AMA, payer guidelines, and NCCI edits while performing internal audits and peer reviews to uphold compliance and reduce denial risk.

    Step 4

    Ready to submit

    Finalize coded encounters and transmit the validated code set to the billing department or RCM system for claim preparation and reimbursement processing.

    The Benefits of Revex Square Outsourcing Eligibility Verification Services

    Mitigating Denial Ratio

    Outsourcing eligibility verification allows you to prioritize your bottom line and mitigate errors in the system, reducing the denials Ratio.

    Improves Cash Flow

    Access to up-to-date eligibility data enhances claim approval and processing speed, ensuring consistent cash flow for the firm.

    Low Operational Costs

    We understand that in-house verification can be costly. That’s why our services offer a highly affordable and cost-effective alternative.

    Enhancing Patient Care

    Streamlining the initial phase of RCM enhances practice focus on patient care, resulting in heightened patient satisfaction.

    Easily Scalable Business

    Our eligibility verification services for private practices offer physicians critical leverage to scale their practices to the next level.

    Ensures Accurate Billing

    By verifying patient coverage upfront, our services eliminate surprises, minimize claim rejections, and ensure precise billing from the start.

    Why Choose Outsourced Eligibility Verification Service ?

    Eligibility verification is the cornerstone of the medical billing process, ensuring timely payments. Failing to verify eligibility promptly can lead to delayed payments and increased denials, ultimately reducing revenues.

    Our Eligibility Verification services provide a seamless solution to this critical aspect of revenue cycle management. By entrusting this task to our experts, medical practices can focus on delivering exceptional patient care while we ensure accurate verification. With our comprehensive approach and commitment to accuracy, we streamline operations and maximize revenue potential. Our dedicated team remains vigilant, continuously updating protocols and adapting to changes in insurance regulations, ensuring our clients stay ahead in the ever-evolving healthcare landscape.

    0 %
    Satisfied Clients

    Starting from 2.75%

     

    Eligibility Verification ServiceNear Me

    Searching for a “ Eligibility Verification Service company near me”? Revex Square proudly serves healthcare providers across the USA with dedicated support teams, ensuring a local feel with national expertise. Our team understands the unique billing challenges faced by American healthcare providers and offers solutions tailored to your region and specialty.

      Dr. Guatam J Wankhede, Chiro
      Dr. Guatam J Wankhede, Chiro

      President

      Revex Square’s team is impressively responsive—always addressing within hours. They fight hard with insurance companies to ensure we receive full reimbursements. They also quickly mastered our chiropractic software and integrated seamlessly into our workflow. Their service is reliable, efficient, and fairly priced—I couldn't be more satisfied.

        Farhat Irshad
        Farhat Irshad

        Pediatrics

        Partnering with Revex Square has been a game-changer for our practice. In just six months, they cleared our AR backlog and dramatically improved our billing operations. Their professionalism, attention to detail, and responsiveness have exceeded our expectations. Our practice is now running more efficiently than ever—thank you, Revex Square!