support@rxcredentialing.com

Affordable and Reliable

Insurance Eligibility Verification Services

  • Get every claim paid
  • Affordable Insurance Verification Services
  • Done by experienced Medical VAs
  • HIPAA-trained virtual assistants
  • Coverage verification across 800+ payers
  • Helping you focus on patients.

Let our medical VA handle it. Stop wasting time on insurance calls.

starting from

$ 499

PER MONTH

0 %

First Pass Rate

0 %

Revenue Increase

0 %

Denial Reduction

0 %

Clean Claim Rate

Medical Insurance

Eligibility Verification Services

Tired of wasting hours on hold with insurance companies?

Let RxCredentialing’s HIPAA-trained virtual medical assistants handle your patient health insurance verification

—so you can focus on patient care, not paperwork.

Don’t Let Verification Gaps Cost You Money!

Copay & Deductible Details
Auth Requirements & Session Limits
Active/Inactive Status
HIPAA-Compliant

Reduce Claim Denials by 33% with Expert Insurance Verification

 

Fewer Claim Denials 

Faster Coverage Checks

We catch coverage gaps, auth requirements, and session limits before you bill, reduced denials

No more manual sifting through portals or waiting on hold. Our VAs verify benefits in minutes, not hours.

Fully secured process.

All our staff has gone through HIPAA compliance training.

Insurance Eligibility Service

Whats involved

Confirms Active Coverage

Verifies coverage for relevant cpt codes and ensures services are covered under the patient's plan.

Identifies Telehealth Coverage

Checks for telehealth coverage

Clarifies Patient Costs

Provides clear details on patient copays, deductibles, and coinsurance responsibilities

Flags Authorization Requirement

Identifies services requiring pre-authorization to prevent claim denial

Insurance Eligibility Service

Benefits of our service

Protect Your Revenue Before the Patient Even Arrives

Most denials happen because of eligibility issues. We verify benefits in advance, so you don’t waste time treating uninsured visits or chasing unpaid claims. Every appointment becomes a revenue opportunity — not a risk.

No More Surprise Patient Balances or Write-Offs

When patients don't know their copays, deductibles, or coverage limits, you're stuck explaining bills they didn’t expect. We provide clear, upfront benefit details, so patients are financially informed — and you get paid without uncomfortable conversations or collections.

Your Staff Can’t Keep Up — and They Shouldn’t Have To

Front desk teams are overwhelmed. Eligibility checks often get skipped or done wrong. Our team handles this with precision, every time, using payer portals, phone calls, and tools your staff doesn't have time or training to use — ensuring nothing falls through the cracks.

Avoid the Hidden Costs of In-House Mistakes

Doing it in-house may look cheaper — until you see the cost of denials, delays, billing errors, lost productivity, and provider frustration. With us, you get a dedicated team focused solely on protecting your income — without the HR burden or management headache.

Medical Insurance Eligibility

Verification process

Gather Patient Information

We start our insurance eligibility verification process by collecting relevant patient information, including demographic details, insurance ID, payer details, and policy number. This step gives us all the information we need to accurately verify the patient’s insurance eligibility.

Verify Plan Coverage

Next, our experts visit the concerned insurance companies’ websites or portals to validate patient details. We also contact insurance payers to confirm that the patient information, such as plan type, policy number, copays, deductibles, network participation, and coverage exclusions, is up to date.

Evaluate Coordination of Benefits

Some patients have multiple insurance plans . Therefore, we evaluate the Coordination of Benefits (COB) between primary and secondary payers to determine payment responsibilities and avoid billing errors. This step clarifies payment order and coverage limitations.

Obtain Prior Authorization

Next, we identify services or treatments that require prior authorization. In cases where a pre-authorization is necessary, we fast-track the process to secure written approvals from the insurance payer, minimizing the risk of treatment delays and possible claim denials.

Documenting

After confirming everything with the patient and payer, we update all the information, such as plan benefits, exclusions, and limitations, in your EHR or practice management software. This step helps you maintain accurate patient records and simplifies the claim submission process.

Benefits of Outsourcing

Insurance Verification Service

Benefits of Outsourcing Insurance Verification

More Revenue

Increase collections with accurate verification and reduced denials

Fewer Surprises

Know coverage details before sessions to prevent unexpected costs

Cost Saving

Reduce operational costs by eliminating in-house verification staff

Reduce Denials

Minimize claim rejections with thorough upfront verification

Higher Clean Claim Rates

Submit claims correctly the first time with accurate information

Know Coverage Details

Verify benefits, copays, and deductibles before appointments

Focus on Patients

Free your staff from insurance calls to concentrate on patient care

Trained Experts

Access specialists with deep knowledge of insurance verification

Quick Verification

Get insurance details verified within 24-48 hours of submission

All Major

Specialties covered

FAQ

Ask us anything

 

Most front desk staff are juggling multiple tasks—calls, patients, scheduling—and eligibility often gets rushed or skipped. Our team is fully dedicated to verification, using payer tools, portals, and phone calls to ensure every detail is accurate and up to date.

 

We verify patient coverage, active policy status, copays, deductibles, out-of-pocket limits, specialist referrals, and prior authorization requirements. Everything you need to ensure clean claims and avoid costly denials.

 Verifying eligibility before the visit reduces denied claims, billing errors, and unpaid balances. That means faster payments, fewer write-offs, and more consistent revenue.

 

 Yes. We send detailed eligibility reports daily or weekly (depending on your preference), showing the verification status, benefit details, and any red flags that need attention before the visit.

Absolutely. Our team follows strict HIPAA guidelines to protect patient information and ensure full compliance with federal and payer standards.

 

In many cases, yes. we can directly update patient records. Otherwise, we send secure reports for your staff to upload or reference.

We serve all outpatient specialties, including primary care, psychiatry, mental health, physical therapy, pediatrics, and more. We tailor the verification process based on the unique needs of your specialty and payers.

Insurances Covered

Insurance Verification Service

Insurance Providers

Locations

Serving Nationwide

Enjoy faster verification across the nation! Our insurance eligibility verification services are now available in all 50 states.

So, wherever your practice might be, don’t hesitate to contact our expert team to unburden your administrative staff.

Let us help you with coverage checks and quicker approvals so your patients don’t have to wait for their right to access quality

Trusted by Providers Nationwide.

Verified Credentialing Results

We strive to maximize your revenue & reduce expenses with our expertise to handle your insurance eligibility services.

Get your concerns resolved in real time.

Talk to your dedicated manager whenever you want.

We can create all insurance portals for your office, which you can use to check real-time patient eligibility and benefits at no cost.

"

"Their real-time eligibility verification catches inactive policies before we see patients. They identified that 22% of our Medicaid patients had switched to managed care plans we weren't credentialed with - saved us $85,000 in denied claims last quarter!"

MD

Dr. Wilson, MD

Family Medicine Practice

Medicaid • Medicare • Commercial Plans

"

"Their system automatically flags patients whose benefits require pre-authorization for our specialists. The detailed coverage breakdowns show exactly what's covered under each plan's mental health parity requirements - no more surprise denials!"

PM

Patricia M., Practice Manager

Multi-Specialty Healthcare Group

Behavioral Health • Cardiology • Endocrinology

"

"For urgent care, knowing copays and deductibles before treatment is critical. Their API integrates with our EHR and instantly shows which high-deductible plans require payment upfront. We've reduced bad debt by 37% while improving patient satisfaction."

UC

Dr. Chen, DO

Regional Urgent Care Network

HDHPs • ACA Plans • Employer Groups

Experience team

Lead by Expert

Adam’s helped hundreds of healthcare providers start, grow, and sustain medical practices by providing 100% customer-focused, quick-response, and affordable solutions.

Get in touch to discuss more.

Adam Blake CEO Rx Credentialing

Get in Touch

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