Insurance eligibility verification
Patient insurance eligibility and benefits verification is the process of validating information such as coverage, copayments, deductibles, and coinsurance with a patient’s insurance company. It is a critical component of medical billing and the overall revenue cycle management (RCM) process. Neglecting this important task is a common cause for medical claim rejections and denials.
Optimize your revenue cycle
Why is it critical to verify patient eligibility and benefits prior to treatment? Having a clear understanding prior to treatment enables the provider to ensure mutual goals are aligned. Specifically, the provider can prepare a treatment plan based on the scope of coverage, out-of-network-benefits and patient responsibility allowances. Medical claims which are processed after verifying benefits get paid faster and eliminate wasted time in the resubmission process. In addition, we advise implementing upfront patient collections to reduce administrative costs, improve healthcare delivery and increase patient satisfaction. Using edgeMED’s eligibility verification tools, providers can improve collections and supercharge their revenue cycle.
People + technology
Flexible channel for receiving workflows through various patient scheduling systems - EDI, fax, emails, and FTP files
Enjoy fast verification of primary and secondary coverage information
Efficient, electronic connectivity with payers via single point platform
Confirm patient demographic and policy information, including benefits and deductibles
We’re the experts you can count on
Increase practice revenue
Lessen certain patient related claim denials
Transparent patient responsibility prior to treatment
Improve patient satisfaction and care quality
Supercharge your practice!
Create efficiencies, streamline your medical organization and get paid more.
U.S. government entities
edgeMED is a U.S. Government Services Administration (GSA) contract holder (contract #47QRAA22D00E8) that provides federal and state governments with revenue cycle management services. Access to edgeMED ordering information, terms and conditions, pricing, and the option to create an electronic delivery order, are available to government entities through GSA Advantage!® at GSAAdvantage.gov.