Eligibility Verification Services
Comprehensive eligibility verification prevents claim denials and ensures accurate patient coverage information. Real-time checks and benefits breakdown help you make informed treatment decisions.
Complete Eligibility Verification
We verify patient eligibility and benefits before treatment to prevent denials and ensure accurate coverage information. Our comprehensive eligibility verification services help dental practices make informed treatment decisions, improve patient communication, and maximize collections. By verifying coverage upfront, we help prevent costly denials and reduce administrative burden.
At Apexita, we understand that eligibility verification is critical to successful claim submission and payment. Our expert team performs real-time eligibility checks with all major insurance carriers, providing detailed benefits breakdowns and coverage information. We verify active coverage, effective dates, network participation, deductibles, maximums, and coverage percentages to ensure accurate information before treatment.
Our eligibility verification services encompass real-time eligibility checks, benefits breakdown and coverage details, deductible and maximum benefit tracking, coverage effective dates verification, network participation confirmation, prior authorization requirements, and automated daily eligibility monitoring. We work with all major insurance carriers including Delta Dental, Cigna, Aetna, MetLife, Guardian, and many others.
Key Features & Capabilities
- • Real-Time Eligibility Checks: Instant verification of patient insurance coverage and active status with insurance carriers
- • Benefits Breakdown & Coverage Details: Detailed breakdown of patient benefits including deductibles, maximums, and coverage percentages
- • Deductible & Maximum Benefit Tracking: Track patient deductibles and remaining maximum benefits for accurate cost estimates
- • Coverage Effective Dates Verification: Confirm coverage effective dates to ensure services are covered at time of treatment
- • Network Participation Confirmation: Verify network participation status to determine coverage levels and patient responsibility
- • Prior Authorization Requirements: Identify procedures that require prior authorization before treatment
- • Automated Daily Eligibility Monitoring: Automated monitoring of patient eligibility to catch coverage changes proactively
Why Choose Apexita for Eligibility Verification?
With extensive experience in eligibility verification and direct connections to major insurance carriers, Apexita is your trusted partner for all your eligibility verification needs. We combine real-time technology with expert knowledge to provide accurate, comprehensive coverage information. Our services help practices prevent denials, improve patient communication, and maximize collections.
Eligibility Verification Benefits
Prevent Denials
Verify coverage before treatment to avoid claim denials and reduce write-offs, improving your practice's financial health.
Accurate Information
Get real-time, accurate coverage information to make informed treatment decisions and provide accurate cost estimates.
Improved Cash Flow
Know patient benefits upfront to improve collections and reduce surprises, leading to better cash flow management.
Better Patient Experience
Provide patients with accurate cost estimates and coverage information upfront, improving patient satisfaction.
Verification Process
Patient Information Collection
Collect patient demographic and insurance information for verification, ensuring accuracy and completeness.
Real-Time Verification
Perform real-time eligibility check with insurance carrier to confirm active coverage and benefits.
Benefits Breakdown
Obtain detailed benefits breakdown including deductibles, maximums, and coverage percentages.
Documentation
Document verification results and coverage details in patient record for reference and claim submission.
Get in Touch
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