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I will do insurance eligibility verification and prior authorization
Medical Billing and AR Specialist, Jane App, RCM Expert
Medical billing and RCM specialist for US practices. I handle the full revenue cycle: eligibility checks, CPT/ICD-10 coding, claim submission, payment posting, denial management, AR follow-up and cred...
Über diesen Service
Every unverified patient is a denied claim waiting to happen. I verify eligibility and chase authorizations so your front desk stops calling payers.
ELIGIBILITY AND BENEFITS VERIFICATION
Active coverage confirmed with the payer, not just the card
Copay, coinsurance, deductible met and remaining out-of-pocket
Visit limits, session caps and frequency restrictions
In-network vs out-of-network status for your NPI
Telehealth coverage and modifier rules
Secondary coverage and coordination of benefits
A clear summary sheet per patient, readable in seconds
PRIOR AUTHORIZATION
Whether an auth is required, before you schedule
Submission through payer portals, fax or phone
Clinical documentation assembled and attached
Follow-up until approved. I do not submit and hope
Expiry tracking and renewals before sessions get denied
Appeals and peer-to-peer requests on denied auths
PAYERS: Medicare, Medicaid, BCBS, Aetna, Cigna, UnitedHealthcare, Optum, Humana and TRICARE.
Eligibility within 24 hours. Authorizations started the same business day. HIPAA compliant, BAA signed before any PHI is shared.
Send me one patient to verify as a test before you commit to more.
Zweck:
Business
Arbeitsmodell:
Projektbasiert
•
Monatliches Honorar
FAQ
How fast is eligibility verification?
Same or next business day for most payers. Portal-only plans can take a little longer, and I flag those upfront so you are never waiting without knowing why.
What happens if an authorization is denied?
I request a peer-to-peer review or file an appeal with the clinical documentation attached. A denied auth is not the end of it, and working the appeal is included, not billed as an extra.
Can you verify telehealth coverage?
Yes, including which modifiers and place-of-service codes each payer currently requires. Telehealth rules change often, so I confirm them per payer rather than assuming last year's rules still apply.
How do I send patient information securely?
Encrypted file transfer or directly inside your EHR. Never plain email, and never Fiverr chat attachments for PHI. I sign a HIPAA BAA before any patient data changes hands.
Do you work US hours and weekends?
I overlap with US business hours and reply within a few hours. Orders are accepted any day, but payer portals and phone lines run on weekdays, so weekend orders start Monday morning.
