Eligibility & prior eligibility
Verify coverage before the visit, not after the denial
Knowing a patient’s benefits and financial responsibility before services are delivered closes the gaps that inflate A/R days after billing. When coverage isn’t checked, revenue is lost and the delay ripples through every reimbursement that follows.
That’s why eligibility should be verified every time a patient comes in. MTS runs a fast, thorough insurance verification process so claims are accepted the first time, denials and write-offs fall, and payments arrive sooner.
What’s included
Complete eligibility and benefits verification
Active coverage checks
Confirm the policy is active for the date of service and the patient details match payer records.
Benefits & patient responsibility
Copay, deductible, coinsurance and out-of-pocket status captured for your front desk.
Primary & secondary coverage
Coordination of benefits identified so claims go to the right payer in the right order.
Authorization flags
Services that need prior authorization are flagged early and handed straight to our authorization team.
Every visit, not just the first
Re-verification on each appointment catches plan changes and terminated coverage.
Updates in your system
Verified details recorded in your practice management system for your staff and billing team.
How we work
A simple, repeatable verification workflow
We work from your schedule so every patient is verified ahead of their appointment.
Receive the schedule
We pick up upcoming appointments from your system.
Verify coverage
Eligibility and benefits confirmed with each payer.
Contact the patient if needed
Missing or outdated insurance details followed up before the visit.
Update your billing system
Results recorded so the claim is built on accurate data.
Why eligibility verification pays for itself
- Fewer eligibility-related denials and rejections
- Lower days in A/R and steadier cash flow
- Accurate patient cost estimates at check-in
- Less rework for your front desk and billers
FAQ
Common questions
How far ahead do you verify?
We work from your appointment schedule so verification is completed before the patient arrives. We’ll agree the exact timing with you during onboarding.
Can you verify eligibility for walk-ins or same-day visits?
Yes. Let us know how your practice schedules same-day patients and we’ll build a workflow around it.
Do you also handle prior authorizations?
Yes — services that need authorization are passed straight to our prior authorization team.
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