Transforming insurance eligibility verification
Because insurance companies are regularly making policy changes and updates in their health plans, it is important for Physician Groups and Hospitals to do the following:
- Verify if the patient is covered under the plan
- Verify the DME or procedures will be paid
- Verify the patient responsibility to maximize patient collections and avoid patient dissatisfaction.
To address these, EqualizeRCM has developed Verifier. This AI-driven smart solution can be implemented using a flexible model:
- Subscribe to Verifier for your team
- Work with our associates to utilize Verifier on your behalf
- Or, adopt a blended approach where Verifier and our associates supplement your existing team
Verifier will make your benefits verification process more efficient, minimize costs, improve the clean claim rate, and reduce patient complaints.
An automated solution to human error
EqualizeRCM provides AI-driven smart Benefits Verification solutions to help Physician Groups and Hospitals reduce costs and improve the clean claim rate by eliminating human errors. Most insurance verification software tools deliver only basic patient insurance information such as coverage, deductible, copay, and coinsurance. Verifier collects this information and also provides a list of “conditional branching” (or “skip logic”) – algorithm-based questions – to determine coverage for specific DME or procedures.
How Verifier works
Verification of coverage for products and specialized services often requires a telephone call with the insurance representative. Based on the patient’s insurance, the products (i.e. DME Orthotics) or procedures (i.e. Angioplasty), and the location of services, Verifier populates the specific coverage questions to be asked of the insurance company based on the proprietary conditional branching (or “skip logic”). This ensures the proper information is gathered at a fraction of the cost of calling without Verifier.
The benefits to Verifier users are impressive:
- Services can be provided at a fraction of the costs
- Reduces benefits verification staffing needs
- Allows your staff to spend more time with the patient
Request a demonstration
We’re excited to show you how well Verifier can work for you. Just complete the form below and ask for a Verifier demonstration.