Eligibility Verification and Prior Authorizations

ELIGIBILITY VERIFICATION
It is not unusual for an employer to change employee health plan offerings each year, or for employees to switch plans annually, as each group looks for ways to reduce expenses. These frequent, ongoing changes increase the importance of accurate, upfront eligibility and benefits verification for all healthcare providers. Having access to the most up-to-date eligibility and benefits data increases clean claims rates, eliminates costly rework and accelerates reimbursement.

PRIOR AUTHORIZATIONS
Prior authorization is a process used by health insurance companies in most states to determine if they will cover a prescribed procedure, service, or medication. The process is intended to act as a safety and cost savings measure, although it has received criticism from physicians for being tedious, time consuming and expensive. In certain states like CA, almost all patient visits in certain specialties require a prior authorization, including follow up visits. Allowing GoSoft to obtain all prior authorizations for the office significantly saves time and fosters a patient-centric focus by the front desk. In addition, this is a very significant step in preventing delayed payments and speeding up reimbursements.

Why Choose GoSoft

FREE ASSESSMENT

OUR PROCESS WORKS LIKE CLOCKWORK.

Completing Prior Authorizations in a timely manner is one of the most important tasks necessary for improving collections.  Most offices do not manage this process/workflow properly and face substantial losses.  This process is usually managed by front desk staff or a dedicated individual depending on the size of the office.  When your staff is on vacation, the prior authorizations are left pending which results in decreased collections.  When GoSoft takes over your eligibility verification and prior authorization processes, you can practice hassle-free with peace of mind and maximize revenue.
FREE ASSESSMENT

What Our Clients Say

After GoSoft has taken over our patient verifications and authorizations, our staff has a lot more free time. Our patients like the attention they receive from our staff. We don’t have to worry about our verifications and authorizations anymore, since their service works like clock work. There are hardly any mistakes in their workflow. Also, how can I not mention the cost savings and not needing to manage vacations, time offs, etc.
Chula Vista Cardiac Center