Est. 2014 Bridging Healthcare & Revenue
✉ info@carebridgercmsolution.com 📞 022-39482200
OPERATIONAL METHODOLOGY

Specialized Execution Built for Healthcare Organizations

Over 40% of healthcare claim denials originate at the front desk due to expired coverage, unverified policy numbers, or missing prior authorizations. CareBridge's front-end eligibility verification team eliminates these risks before the patient receives care.

We verify active insurance coverage, effective dates, copays, remaining deductibles, co-insurance percentages, out-of-pocket maximums, and payer plan networks 48 to 72 hours prior to scheduled encounters. By ensuring accurate insurance data at intake, providers collect correct point-of-service patient liabilities and avoid costly back-end rework.

MEASURABLE PRACTICE OUTCOMES
  • ✓ Reduces front-end eligibility denials by up to 94%
  • ✓ Increases upfront point-of-service (POS) patient collections
  • ✓ Prevents surprise billing issues and improves patient financial transparency
  • ✓ Ensures patient demographic and policy details match payer databases exactly
STRUCTURED WORKFLOW

Execution Stages

01 Daily appointment schedule extraction 72 hours in advance
02 Electronic eligibility query and telephonic payer validation
03 Benefits and patient financial liability entry directly into practice EHR
04 Flagging of authorization requirements or coverage discrepancies for clinic staff
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TECHNICAL SCOPE

Comprehensive Workflow Capabilities

Detailed operational deliverables included in our Insurance Eligibility & Verification engagement models.

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Electronic EDI 270/271 real-time inquiry and telephonic payer verification
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Copay, deductible, co-insurance, and out-of-pocket maximum calculations
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Primary, secondary, and tertiary payer coordination of benefits (COB) discovery
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Payer network status confirmation (In-Network vs. Out-of-Network)
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Prior authorization requirement identification and initiation
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Batch pre-registration verification for upcoming clinical appointment rosters
SEAMLESS TECHNICAL INTEGRATION

Compatible with Leading Healthcare EHR & Practice Management Platforms

Epic Systems Cerner / Oracle Health Athenahealth eClinicalWorks (eCW) Kareo / Tebra NextGen Healthcare AdvancedMD DrChrono Allscripts / Veradigm
TRANSFORM YOUR RCM PERFORMANCE

Ready to Optimize Your Insurance Eligibility & Verification?

Connect with our healthcare RCM specialists to evaluate your current billing performance, resolve bottlenecks, and design a customized delivery model.

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