When eligibility and benefits verification is not conducted effectively, it can lead to several negative outcomes:

Increased Claim Denials:

Unverified eligibility often results in denied claims because services are rendered to ineligible patients.

Delayed Payments:

Payment processes are slowed down, affecting the financial health of healthcare providers.

Additional Rework:

Inaccurate or incomplete verification necessitates extra administrative effort to rectify issues.

Patient Care Delays:

Patients may face delays in accessing needed care due to verification issues.

Decreased Patient Satisfaction:

Inadequate verification can lead to unexpected costs for patients, reducing their satisfaction.

By conducting comprehensive eligibility and benefits verification, we aim to streamline the revenue cycle for healthcare providers, enhancing both provider and patient experiences.