Call Us 24/7(607) 225 5002
E-mail Us 24/7info@caremedox.com
Call Us 24/7(607) 225 5002
E-mail Us 24/7info@caremedox.com
For healthcare providers and practice managers, our free audit / consultation request form is the simplest way to connect with our team. Whether you have questions about our services, need clarification on specific offerings, or would like to explore customized solutions for your practice, we appreciate you to please fill the form. Please feel free to share any inquiries, concerns, or details you would like us to review—nothing is too small or too complex. Once submitted, our specialist team will come back to you and schedule a dedicated consultation at your convenience. We are committed to supporting you, addressing your questions with clarity, and ensuring you feel fully informed and confident moving forward.
info@caremedox.com
(607) 225 5002
At CareMedox, we know that one of the most critical steps in your revenue cycle begins before a patient even receives care. With our Advance Eligibility Verification Services, we make sure your patients' insurance coverage, benefits and financial responsibilities are confirmed in advance—so you can minimise surprises, reduce denials and maximise clean claims.
Verifying eligibility ahead of service helps avoid key issues like inactive coverage, missing benefits or unmet pre-authorisations.
When coverage and financial responsibility are confirmed early, you submit cleaner claims and reduce payment delays.
Patients appreciate knowing their coverage and out-of-pocket costs up front rather than being surprised later.
By outsourcing this front-end verification, your team can focus on clinical operations while our experts handle insurance checks and benefits clarifications.
The insurance landscape evolves rapidly; we keep on top of plan changes, payer rules, authorisations and benefit limitations so you don't have to.
Here are the key components of our RCM offering
We proactively verify the patient’s insurance plan status, policy effective date, termination date, network participation, scope of coverage (professional vs institutional), and whether the planned services are included.
We evaluate patient cost-sharing obligations—deductibles, copays, coinsurance, out-of-pocket maximums—and identify any gaps in coverage or services excluded by the payer.
For patients with multiple insurance plans, we verify primary vs secondary payer roles, payment order, and benefit interplay to avoid billing confusion and delayed payments.
We check if the upcoming service requires authorisation or referral per the patient’s plan, and confirm whether the authorisation has been obtained or is pending—reducing the risk of denial based on authorisation errors.
Once verification is complete, we can generate a summary of the patient’s coverage and approximate financial responsibility and communicate with your team or directly with the patient (as you prefer) so there are no bill-surprise moments.
Our verification process is fully documented—date/time of verification, payer summary, patient cost-sharing, authorisation status—and we provide you with clear reports so your billing and front-desk teams are aligned.
We analyse your current registration/verify processes, identify gaps (e.g., last-minute checks), and tailor our verification workflow for your practice.
We integrate with your practice management or EMR system, define data capture fields, set up verification triggers (e.g., at scheduling, 48h before service).
Our team conducts the checks, obtains plan details, identifies risks or gaps, logs results, and flags accounts needing attention.
Verified information is shared with your staff (or patient) and next steps (e.g., collect copay prior, schedule authorisation) are triggered.
We monitor metrics such as verification completion rate, number of uncovered services identified, reduction in denials, and refine process over time.
Fewer claim rejections or denials due to eligibility issues
Faster submission of 'clean claims' with higher first-pass acceptance
Better patient satisfaction because coverage is clear up front
Reduced time spent by your staff on chasing missing coverage
Stronger cash flow because fewer surprises = fewer delays
Whether you are a small clinic, a multi-specialty group or a large institutional provider, if you're looking to reduce billing risk, improve front-end registration accuracy, and strengthen your revenue cycle from the very first touchpoint — then our Advance Eligibility Verification Service is for you.
Let's work together to turn verification into a strategic advantage rather than an administrative burden. Contact us today to discuss how we can implement this service for your practice.