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Revenue Cycle Management
Insurance Eligibility Verification Services
Revenue Cycle Management

Insurance Eligibility Verification Services

RekhaTech’s insurance eligibility verification services check patient coverage, benefits, and limits before every visit — catching issues weeks in advance so your practice never submits a claim against inactive or incorrect coverage.

Overview

Catch Coverage Problems Before They Become Claim Problems

Most eligibility errors are discovered when a claim bounces — days or weeks after the visit. By then, the patient is gone, the coverage has changed, and the denial process begins. RekhaTech eliminates this by running automated eligibility sweeps daily across all appointments scheduled in the next 20 days. CMS eligibility verification requirements apply to every Medicare and Medicaid claim — automated daily sweeps ensure your practice is always compliant. Every morning, our system checks active coverage, verifies benefits, and flags any discrepancy — giving your team enough lead time to resolve the issue, contact the patient, or request authorization before a single claim is ever filed.

  • Automated daily eligibility sweeps across all appointments scheduled in the next 20 days
  • Coverage discrepancies flagged weeks in advance — not the morning of the visit
  • Benefits verification including co-pays, deductibles, and authorization requirements
  • Patient communication for coverage issues before their appointment date

Automation-Powered

Daily Eligibility Sweeps — 20 Days Out, Every Morning

Every day, RekhaTech’s automated eligibility system checks active coverage for every patient with an appointment in the next 20 days. When coverage is inactive, benefits have changed, or an authorization is required, the system flags it immediately — giving your team weeks of lead time to resolve the issue before it affects a claim or a scheduled visit. This is not a morning-of check. This is a rolling, proactive sweep that catches problems while there is still time to fix them.

What’s Included

What’s Included in Eligibility Verification

Daily Automated Sweeps

Eligibility checked automatically every morning for all appointments in the next 20-day window — no manual batch processing.

Real-Time Payer Verification

Live eligibility checks against payer systems — not cached data that may be days old when coverage status matters.

Benefits Breakdown

Co-pays, deductibles, coinsurance, and out-of-pocket maximums verified and documented — reducing patient billing surprises.

Authorization Flag & Escalation

When a procedure requires prior authorization, the system flags it for immediate submission — no authorization slips through.

Patient Outreach for Coverage Issues

Patients notified before their visit when coverage is inactive or changed — giving them time to resolve before arrival.

Eligibility Reporting

Daily and weekly reports on verification status, flagged accounts, and coverage exception rates by payer.

20 Days
Advance Verification

Every scheduled appointment verified up to 20 days out — not the morning of the visit when it’s too late to act.

Daily
Automated Sweeps

Eligibility system runs every morning — coverage changes between booking and appointment are caught automatically.

Zero
Missed Authorizations

Authorization requirements flagged at eligibility check — before the visit, not after the claim is denied.

Engagement Model

Dedicated Eligibility Team or Full Revenue Cycle Coverage?

Eligibility is often best handled as part of a broader front office engagement. The Managed Resource (FTE) model deploys a dedicated eligibility team inside your workflow at fixed cost — you control the process, RekhaTech provides the staffing and quality assurance. If you want full front-to-back revenue cycle management with financial accountability on collections, the Percentage-Based model covers everything.

Compare both engagement models

Recommended
Managed Resource

Dedicated FTE resources, supervised by RekhaTech, working inside your workflow. Fixed cost, full control.

Also Available
Percentage-Based

Full end-to-end ownership. RekhaTech is compensated on collections — our incentives are aligned with your revenue.

Daily Eligibility Sweeps Run — With or Without an Individual Present.

The 20-day automated eligibility sweep runs every morning regardless of staffing. But when flags are raised — coverage discrepancies, missing authorizations, lapsed policies — a trained specialist needs to act on them the same day. RekhaTech’s bench model ensures that human follow-up never stalls because one person is out. Your assigned eligibility specialist has a trained backup who knows your practice’s scheduling patterns and payer requirements and can pick up open items without a handoff delay.

Learn how RekhaTech’s staffing model works

How Many Claims Are You Filing Against Bad Coverage?

Book a free eligibility audit. We’ll show you how many of your recent claims had coverage discrepancies that could have been caught before the visit.

Book Free Assessment
No commitment · Response within 24 hours