Insurance Eligibility Verification

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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.

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Benefits of Insurance Eligibility and Benefits Verification Services

• The provider can gather the actual collectible from the patient during the visit.
• Providers will know if the services are covered under the patient plan.
• The provider billing team will identify the correct insurance plan (Plan type) where the claim needs to be sent, and denials can be reduced.

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Minimize Denials

The automated eligibility verification process can also reduce claim denials from non-covered services, members not active, providers not eligible to render assistance, etc.

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Streamline Process

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.

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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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Specialty We Handle:

Anesthesiology, Cardiology & Cardiovascular Surgery, Critical Care, Dermatology, Diagnostic Radiology, Emergency Medicine, Family Medicine, General Surgery, Internal Medicine, Long-Term Care, Mental Health, Neurology & Neurosurgery, Occupational Therapy, Pain Management, Physical Therapy, Podiatry, Psychiatry, Radiology’s, and Urgent care.

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