Eligibility & Benefits Verification (EV/BV) Services

Validate coverage before the visit to stop front‑end denials, set clear patient expectations, and accelerate reimbursements. Our team verifies eligibility in real time, manages pre‑auths and referrals, and documents every payer interaction inside your EHR/EMR.

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Service Overview

DeehealthIQ’s EV/BV suite confirms insurance details and authorization requirements ahead of service. We check co‑pays, deductibles, coinsurance, plan limits, carve‑outs, and exclusions; manage pre‑authorizations; and return clear notes and call references into your system, so check‑in is smooth and claims are clean on first submission.

Core Capabilities — Eligibility, Benefits & Authorizations

We verify insurance eligibility, benefits, and pre‑authorizations before the visit and push structured notes into your EHR/EMR—preventing front‑end denials and speeding check‑in.

Live Coverage Verification

  • Real‑time eligibility via payer portals, APIs, and 270/271 EDI transactions
  • Confirm plan active status, PCP selection (where required), and COB
  • Capture co‑pay, deductible, coinsurance, and out‑of‑pocket remaining
  • Validate plan limits, visit caps, exclusions, and network status

Benefits & Authorization Management

  • Identify requirements for pre‑auths, referrals, and medical necessity
  • Create and follow up on auth requests; obtain and record authorization numbers
  • Track benefit accumulators and lifetime maximums
  • Time‑stamped notes with payer call reference IDs

System Integration & Automation

  • Work inside your EHR/EMR and scheduling system to flag exceptions
  • Queue‑based workflow for same‑day verifications and rescheduled patients
  • Templates for EV/BV notes and financial responsibility summaries
  • Daily summary reports for unresolved items and high‑risk cases

Patient Financial Engagement

  • Pre‑service cost estimates and OOP summaries
  • Scripted communications for payment options and financial counseling
  • Proactive notifications for missing/invalid insurance

Key Benefits

Our EV/BV program improves cash flow and patient experience by preventing front‑end errors and clarifying financial responsibility before care.

  • Fewer eligibility denials — Catch ineligible plans, inactive coverage, and missing auths before submission.
  • Faster reimbursements — Cleaner claims and fewer reworks shorten revenue cycle time.
  • Stronger patient experience — Clear expectations on benefits and OOP costs reduce surprises and billing calls.
  • Efficient front desk — Standardized checklists and templates reduce manual re‑verification.
  • Better visibility — Weekly EV/BV dashboards highlight denial trends, payer outliers, and pending authorizations.
Industry expertise
Seamless onboarding
Data‑driven insights
Transparent reporting
Process Blueprint

Why Partner with DeehealthIQ for EV/BV

We blend payer expertise with disciplined SOPs to prevent denials before they occur. Our team operates inside your EHR/EMR, aligns with your scheduling cadence, and provides clear, auditable documentation every day.

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Next‑Step Conversation

Ready to Transform Your Operations with us?

Let’s discuss how a single, strategic partner can streamline your revenue cycle and fuel your digital innovation.

Phone

+91 8328191964

Email

info@deehealthiq.com

Address

FLAT NO 125, PAPAMPETA, BHGYANAGAR, Ramnagar Ananthapur, AP- 515004.

Get in Touch

Feel free to get in touch with us

FAQs

We support major commercial, Medicare, and Medicaid payers nationwide, including PPO, HMO, EPO, POS, and exchange plans.

Most clinics go live within 2–3 weeks. We align to your EHR/EMR build, scheduling, and existing reports.

We combine portal/API results with manual validation for edge cases and document payer call references for audit trails.

Yes. Clear OOP estimates and upfront benefit explanations reduce surprises and improve first‑time payments.

Start your EV/BV transformation today

Protect your revenue and enhance patient satisfaction with disciplined eligibility and benefits workflows. Share your payer mix, scheduling patterns, and report preferences—we’ll configure a pilot in 2–3 weeks.

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