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Insurance eligibility verification is a critical foundation for a strong and successful Revenue Cycle Management (RCM) process. Even a single error in verifying a patient’s insurance coverage can result in costly claim denials, delayed payments, and significant disruptions to your cash flow.
At Mediflows Billing Solutions, we understand that healthcare providers can’t afford such financial setbacks. That’s why we offer precise, timely, and HIPAA-compliant insurance verification services to ensure every patient is covered correctly before the point of care.
Our goal is simple:
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Instantly confirm patient coverage through integrated systems and payer portals to ensure faster check-ins, smoother workflows, and fewer claim denials.
Access detailed benefit breakdowns, including copays, deductibles, coinsurance, out-of-pocket maximums, and plan limits ensuring accurate billing and preventing surprise patient charges.
Automatically flag services requiring pre-authorization to reduce claim rejections, speed up approvals, and improve patient satisfaction from day one.
Verify all layers of patient coverage — including secondary and tertiary plans — to ensure complete reimbursement and minimize claim denials due to coordination of benefits.
Accurately estimate the patient’s out-of-pocket costs before service to improve transparency, reduce billing disputes, and support faster collections.
Retrieve real-time policy details including plan type (HMO, PPO, Medicare Advantage, etc.), group number, effective/termination dates, coverage rules, and limitations.
Identify and validate out-of-network benefits, including co-insurance rates and prior approval requirements, helping manage patient expectations and reduce revenue loss.