Many patients are not aware whether their insurance plan covers the particular treatment they are willing to take. They repeatedly declined to pay for the services not covered in their insurance plan. Several healthcare providers face revenue loss because of this. To combat this loss, Plutus Health Inc. Provides automated insurance eligibility and benefits verification services to all healthcare providers to stay protected from losses.
Eligibility Verification (EV) is the checkpoint used to verify and confirm the patient's eligibility to take the service from the assigned provider. It increases the revenue and decreases the providers aging days.
The automated eligibility verification process can also reduce claim denials from non-covered services, members not active, providers not eligible to render assistance, etc.
A good EV can quickly increase the first pass and clean claim ratios. But, for flawless results, the providers must set a definite process, and the same need to be maintained in the log for future references.
Plutus Health Inc. is a tech- enabled RCM service provider where we verify eligibility using automations. This Automation is derived by connecting the APIs of the respective practice management systems, Payer portals, Clearinghouse, and Third-party solutions.
We have designed the AI-enabled RCM tools to provide the input file for verification. It will connect through the source web API and get the output.
We have full insurance coverage to verify the eligibility using electronic payer IDs. We also provide a manual insurance eligibility and benefits verification services for payers who do not have EPID.
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