Pre-coverage Validation


A critical aspect of the medical billing process involves examining and confirming the patient's eligibility and benefits before arranging their appointment.

We communicate with the payers to address any financial obligations the patient must meet before or after treatment. Our team of skilled tele-callers conducts this validation procedure within a 24-hour timeframe.


The elements that the OneLife RCM team verifies include:


Activation date and policy specifics


Plan category

Eligible payouts

Cost-sharing amount

Excesses

Co-payment collaboration

Claims correspondence address

Recommendations and prior approvals

Pre-existing condition provision

Maximum lifetime coverage

Additional relevant details

This data is gathered and confirmed ahead of the patient's appointment date. This aids in obtaining referrals, prior authorization codes, and streamlining billing procedures. It also serves to avert claim rejections arising from ineligible benefits and qualification issues.

Upon the conclusion of the validation procedure and the patient's interaction with the healthcare provider, treatment strategies are formulated.