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Eligibility & Benefits Verification

Reduced Errors. Increased Reimbursements.

Experience minimal rejections and improved submission of clean claims with the help of our exceptional eligibility and benefits verification services.

48
hr
TAT
98
%
accuracy
48
hr
TAT
98
%
accuracy
48
hr
TAT
98
%
accuracy
48
hr
TAT
98
%
accuracy
What we offer

Eligibility & Benefits Verification

Eligibility and Benefits Verification is the process of checking the policy details, which includes co-pay, deductible, member ID, and the benefits information of the patient. The information is verified through various channels, including payers and patients, and modes- portals, phone calls, faxes, and emails.

Enhanced Clean Claims Rate (CCR)

Our detailed verification system, accurate data entry, and clear communication with patients and insurance companies all work together to minimize claim denials, speed up reimbursements, and improve your revenue cycle.

helps with

  • Minimizing claim denials
  • Speeding up reimbursements
  • Improving revenue cycle efficiency

Real-time Data Entry and Verification

Our team connects with insurance companies through phone calls and portals to cross-check information. This ensures informed decision-making and a streamlined eligibility verification process.

helps with

  • Informed decision-making
  • Streamlined eligibility verification

Proactive Contact with Patients

Synova improves eligibility verification accuracy and efficiency by contacting patients directly. This allows for data-driven treatment plan decisions, optimizes billing, and minimizes potential reimbursement issues.

helps with

  • Data-driven treatment plan decisions
  • Optimizing billing
  • Minimizing reimbursement issues

Routine Follow-up with Insurance Carriers

Our eligibility verification specialists routinely follow up with insurance carriers to ensure accurate and up-to-date patient information for each visit. This reduces denial risks and improves process efficiency.

helps with

  • Ensuring accurate patient information
  • Reducing denial risks
  • Improving process efficiency

Find what’s Right for you

Discover how Synova can unlock value through our customized solutions across all stages of your healthcare journey. From optimizing operations to enhancing patient care, we're here to support your journey toward excellence in healthcare delivery.

Challenges We Solve

Choosing Eligibility & Benefits Verification

Ineligibility Issues

Denials due to ineligibility are a major financial burden for medical practices. Up to 75% of claims can be rejected because a patient isn't covered for the treatment. This can happen due to inaccurate patient information, outdated details, or other issues. Synova uses real-time collaboration with insurance companies to ensure accurate information and reduce ineligibility denials.

Complex and Changing Healthcare Dynamics

Owing to the complexities involved in the healthcare industry, patients fail to understand the nuances of their insurance coverage, as well as the information about the hospitals or doctors falling under their network. Synova addresses this by proactively contacting patients to clarify these complexities.

Revenue Leakage

Prioritizing eligibility verification minimizes revenue leakage caused by claim rejections and denials. It also strengthens patient collection efforts and prevents payment delays, ultimately optimizing your revenue cycle.

Measurable Impact

98
%
accuracy
48
hr
TAT
Customized Solutions

Designed for your Requirements

Our service solutions streamline operations, enhance patient engagement, and integrate advanced clinical support technologies, tailored to meet your specific needs with efficiency and excellence.

Reduced Denials and Rejections

Prior to service delivery, verifying patient eligibility and benefits ensures services align with their insurance coverage. This proactive approach minimizes claim denials and rejections due to ineligibility or lack of coverage, streamlining the claims processing experience.

Accurate Demographic Information

Eligibility verification allows practices to accurately determine a patient's insurance coverage and report demographic information on the claim form.

Reduced Payment Delays

Synova offers in-house data verification software which is fast and accurate, reducing payments delays.

Reduced Administrative Costs

Synova automates eligibility and benefits verification, reducing administrative costs associated with manual processes. This minimizes errors and manual interventions, leading to increased operational efficiency.

Optimized Revenue Cycle

Accurate verification at the initial patient encounter establishes a solid foundation for a smooth revenue cycle. It ensures all subsequent steps, from coding and billing to collections, are based on verified information, optimizing overall revenue cycle performance.

how it works

How Synova Is Integrated with your Business

Synova integrates seamlessly into business operations by deploying advanced technologies and specialized expertise in healthcare operations management. This integration optimizes processes, enhances efficiency, and ensures compliance, supporting sustainable growth and improved patient care outcomes.

01

Collect Patient Information

The initial step involves the meticulous gathering of essential patient details. This encompasses personal information, insurance data (including provider name, policy and group numbers), and any other pertinent information. Typically, this collection occurs during patient registration or prior to the scheduled appointment.

02

Verify Eligibility

We verify the patient's coverage and active status through an automated eligibility verification system or by contacting the payer.

03

Confirm Benefits

After verifying eligibility, we review the plan to determine the covered benefits, which include co-pays, deductibles, co-insurance, covered services, as well as any exclusions or limitations.

04

Communicate with Patient and Update Records

After verification, we inform the patient about their coverage details and update the Practice Management or Electronic Health Record (EHR) system with the verified eligibility and benefits information.

frequently asked questions

All your Doubts Resolved

What is eligibility and benefits verification?

The process of confirming a patient's insurance coverage and the specific benefits they are entitled to under their insurance plan before providing healthcare services.

How often should eligibility and benefits be verified?

Eligibility and benefits should be verified at the time of scheduling, during pre-registration, and again on the day of the appointment to account for any changes in the patient's insurance status.

Why is eligibility and benefits verification important?

This process is crucial to prevent claim denials and rejections, ensure accurate billing, improve cash flow, enhance patient satisfaction, and minimize financial risks for healthcare providers.

What happens if a patient's eligibility and benefits are not verified?

Failure to verify eligibility and benefits can lead to claim denials, delayed payments, increased patient dissatisfaction, and higher administrative costs due to the need for follow-up and rework.

How is eligibility and benefits verification conducted?

Verification can be done manually by contacting the insurance provider or electronically through automated verification systems that integrate with the provider's practice management or electronic health record (EHR) systems.

Can eligibility and benefits verification be automated?

Yes, for many healthcare providers, Synova uses automated systems that integrate with insurance databases to verify eligibility and benefits in real-time, reducing administrative burden and errors.

What information is needed for eligibility and benefits verification?

Typically, patient's full name, date of birth, insurance provider, policy number, group number, and the specific service or procedure to be verified.

Your Process, Our Technology

Building a Partnership grounded in trust and transparency.

When we build solutions with healthcare organizations like yours, it significantly reduces development and adoption times. We work as partners to solve problems and unlock tangible value.

Accelerated Outcomes
Partnering with Synova reduces development and adoption times, expediting the delivery of efficient revenue cycle solutions.
Value-driven Collaboration
By combining healthcare organizations’ patient-focused experience with Synova’s expertise, our partnership unlocks tangible value and fosters innovation.
Compliance Assurance
Collaborating with Synova ensures solutions are developed to meet industry standards and regulations, fostering trust and delivering high-quality, compliant outcomes.

Bring a change to your Healthcare Operations

A partnership with Synova gives you an inherent:

Adherence towards federal, state, and organizational compliances, as well as safeguarding patient data.

Sense of ownership and commitment towards providing value.

Focus on speed, accuracy, efficiency, and optimal outcomes.

Sense of security and transparency through periodic reporting and actionable insights.

Connect with our experts for a quick analysis and possibilities.

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