According to industry sources, 75% of all health care claim denials are because a patient is not eligible for services billed to the insurer by the provider. Often, a patient would be ineligible for benefits because his or her policy has been terminated or modified.
Global Edge can help practices dramatically reduce their 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 (i.e., claims that are both complete, and are only for patients who are eligible for benefits). Unfortunately, eligibility verification is one of the most neglected elements in the revenue cycle.
In the absence of proper eligibility and benefit verification countless downstream problems are created; delayed payments, rework, decreased patient satisfaction, increased errors, and nonpayment. To avoid these problems, Global Edge provides a remotely hosted Centralized Eligibility Unit for Hospitals and Faculty Practice Plans. The solution consists of Global Edge deploying staff, technology, management and expertise with the objective of delivering high quality cost effective patient insurance eligibility and related services.
Global Edge Eligibility Verification Services has the potential to :
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