Eligibility & Benefits Verification Services

Eligibility errors are one of the leading causes of claim denials across the healthcare industry. At Impact Innovations, we provide accurate, real-time Eligibility & Benefits Verification services that ensure every patient encounter begins with clean, validated coverage information.

Our goal is simple: prevent rejections before claims are even submitted.

Why Eligibility Verification Matters

Inaccurate or missing coverage details can result in:

  • Claim rejections

  • Delays in reimbursement

  • Surprise patient billing

  • Increased administrative workload

We eliminate these risks with proactive and automated eligibility checks.

Our Verification Process

1. Real-Time Patient Insurance Verification

We verify:

  • Active coverage status

  • Plan type & payer details

  • Co-pay, deductible, and co-insurance

  • Referral or authorization requirements

  • Benefit limitations

  • Out-of-network rules

All data is validated prior to service to prevent surprises later.

2. Automated Eligibility Tools

Our system integrates with payer portals and clearinghouses, pulling accurate eligibility information within seconds.

3. Secondary Insurance & Coordination of Benefits

We confirm dual coverage and COB rules to minimize reimbursement gaps and avoid partial denials.

4. Flagging High-Risk Cases

Accounts that require special attention (expired policies, incomplete benefits, authorization needs) are flagged and escalated immediately.

How You Benefit

  • Fewer rejections at the front end

  • Higher first-pass approval rates

  • Minimized staff workload

  • Reduced patient billing disputes

  • Faster claim submission and reimbursement

Start with Accurate Eligibility Every Time

Improve your revenue cycle from the very first touchpoint.

Request a free eligibility workflow audit today.