Benefits, Eligibility and Authorizations
Benefits & Eligibility Verification
Ensuring accurate insurance information is foundational to successful medical billing. Our services include:
Real-Time Insurance Verification
We promptly confirm patients' active insurance status, coverage details, and policy specifics.
Detailed Benefits Analysis
Our team verifies co-pays, deductibles, co-insurance, and coverage limitations, ensuring clarity on patient financial responsibility.
Multi-Plan Coordination
We identify and manage primary and secondary insurance plans, facilitating correct billing sequences.
Technology-Driven Accuracy
Utilizing advanced systems, we minimize errors and expedite the verification process, enhancing overall efficiency.
By outsourcing these tasks, healthcare providers can reduce claim denials, improve cash flow, and enhance patient satisfaction.
Prior Authorization & Management
Navigating the complexities of prior authorizations is essential for timely patient care and reimbursement. Our services encompass:
Comprehensive Authorization Handling
We manage the entire authorization process, from determining requirements to obtaining approvals.
Expert Documentation
Our team prepares and submits all necessary documentation, ensuring compliance with payer-specific guidelines.
Proactive Follow-Ups
We monitor authorization requests, addressing any issues promptly to prevent delays in patient care.
Denial Management
In cases of denial, we analyze the reasons, rectify issues, and resubmit requests to secure approvals.
Outsourcing prior authorization processes can lead to reduced administrative burdens and improved operational efficiency.
Reclaim Time Lost to Administrative Tasks
Nearly 65% of staff spend over 30 minutes preparing just one appeal, and more than 75% of prior authorizations take over 3 days for approval. These delays drain productivity and delay care. Outsourcing these time-consuming tasks to Calyx RCM can streamline operations, reduce burnout, and help your team focus on what truly matters - your patients.