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Eligibility Verification
Eligibility/Benefits Verification and Prior Authorization Services

Streamlining Your Revenue Cycle

Our expert team is dedicated to streamlining your revenue cycle by accurately verifying insurance eligibility and securing prior authorizations—before the patient visit. We work closely with hospitals, clinics, and physician offices to ensure accurate, real-time updates to your revenue cycle systems.

The Impact of Ineffective Verification & Authorization

Poorly executed eligibility and benefits verification or prior authorization processes can significantly disrupt your revenue cycle and patient experience. Common issues include:

Claim Denials

An increase in rejected claims due to eligibility errors.

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Delayed Payments

Extended payment cycles and reimbursement delays.

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Administrative Rework

The burden of administrative backlogs and repeated submissions.

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Treatment Delays

Postponed care and rescheduled appointments.

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Patient Dissatisfaction

Billing surprises leading to unhappy patients.

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Lost Revenue

Unreimbursed services that have already been rendered.

At MedRev, we eliminate these issues through proven processes and specialized support.

Our Step-by-Step Process

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Step 1

Receive Patient Schedule

We receive the upcoming appointment list directly from your provider's office or EHR system.

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Step 2

Enter Patient Demographics

We input patient data into our verification system for both primary and secondary payers.

Step 3

Verify Coverage & Benefits

We check insurance eligibility, ensuring active coverage on the date of service.

  • Copays
  • Deductibles
  • Coinsurance
  • Out-of-network limitations
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Step 4

Initiate Prior Authorization

Where required, we initiate and manage prior authorization requests with payers—ensuring timely approvals for treatments.

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Step 5

Update Your Systems

We document and update your practice management or hospital revenue cycle system with all verified coverage and authorization details.

Key Benefits of Our Services

Faster Care Delivery

Efficient verification and authorization enable timely patient scheduling—enhancing satisfaction and optimizing physician time.

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Fewer Claim Denials

By confirming insurance coverage and securing prior authorizations upfront, we reduce denial rates and accelerate reimbursement cycles.

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Reduced Bad Debt & Higher POS Collections

When patients know their financial responsibility upfront, it leads to improved collections, fewer billing surprises, and better patient trust.

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Industry-Leading Expertise

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We work with all major commercial and government payers—including BCBS, Aetna, Humana, UnitedHealthcare, Medicare, and Medicaid.

Extensive Payer Network

BCBS
Aetna
Humana
UnitedHealthcare
Medicare
Medicaid
Cigna
Anthem
Kaiser
Tricare
HealthNet
Coventry

Why Choose MedRev?

With MedRev as your partner, you gain a proactive team that ensures your practice stays ahead—not behind. From eligibility checks to pre-authorizations, we handle it all with accuracy, speed, and payer-specific expertise.

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Our Commitment to Excellence

  • 24-hour turnaround on most verifications
  • 99.7% accuracy rate on benefit checks
  • Reduction in claim denials by up to 35%
  • Scalable from single providers to large hospital systems