We are a Leading provider of Insurance Verification in Medical Billing solutions

Networth RCM are experts in insurance verification in medical billing. Our experts will know how to get the right information, and can help you understand what questions need to be asked by your claims adjuster, as well as any additional contact points required with them.

We provide accurate, efficient, and cost effective eligibility and verify patient medicare eligibility to healthcare providers. Our eligibility verification services are provided by highly trained and experienced medical billing professionals. We extract patient information from the claim forms and verify the same with insurance payer. We have successfully implemented eligibility verification process for our clients. Our eligibility verification services help healthcare providers in submitting error-free claims, reducing eligibility-related rejections and denials, increases collections, and improves patient satisfaction by avoiding claim re-submission. Additionally, pre-authorization requirements before to providing service reduces denials and helps to enhance collections.

The work log, EDI logs, Fax, emails, and FTP files are how we get our process started. Networth RCM‘s then double-check primary and secondary coverage information, such as the patient’s ID number, group ID, coverage period, co-pay, deductible, and co-insurance information, as well as benefit information. To contact the payer, we phone or look at web portals. We connect with patient, in case of invalid information through a call back or an email.

Our team has extensive experience in verifying eligibility for various insurance plans. Medical claims processing refers to the procedure of submitting a medical claim to an insurance company for reimbursement for services provided by a health care provider. In reality, medical claims processing does not refer to just one process but rather a series of processes that must be completed prior to being paid on submitted claims. These processes include eligibility verification, payment posting, authorization management, contract negotiation, bundling edits management, charge entry.

Pre-authorizations in medical billing are requests made by the provider to the insurance company to cover future expenses. These requests allow the provider to get paid immediately without having to wait months for reimbursement. The insurance company then reviews all the documentation provided by the provider and gives approval or denial for coverage of requested services. A pre-authorization request is only necessary if the service has yet to be performed. If a patient has already received care, then it is an insurance claim (and not a pre-authorization). Pre-authorization requests can also include requests for certain medications as well as some tests or procedures that may be ordered by your office but performed at another facility.