According to industry sources, a lot of claims are denied as the patients are not eligible for the services that are billed to the insurance carriers by the provider or the patients do not have an active coverage. An eligibility and benefits check can help to reduce denials and facilitate acceptance of claim on first submission. But unfortunately, eligibility verification is one of the most neglected process in the revenue cycle. Various problems have been encountered due to non-verification of eligibility and benefits of patients such as delayed payments, rework, decreased patient satisfaction, increased errors, and nonpayment.

We at ecare India access the appointment scheduler and check eligibility/benefits of patients scheduled. This helps in dramatically reduce client's accounts receivable cycle and increase revenue, by significantly reducing the impact of ineligibility, and increasing the number of "clean" claims that are sent to insurers. The claims submitted are both complete (based on the various processes followed by ecare) and are only for patients who are eligible for benefits.