Eligibility & Prior Authorization Services
MedAxis MBS helps healthcare practices verify insurance coverage and manage prior authorization requirements before services are delivered. Our support helps identify coverage issues, coordinate authorization requests, and reduce administrative obstacles that can delay patient care and reimbursement.
Prevent Coverage Issues Before They Impact Your Practice
Unverified insurance details and missing prior authorizations can lead to unexpected patient expenses, postponed procedures, and avoidable claim denials. Managing payer requirements for every appointment can also place a significant burden on administrative teams.
MedAxis MBS helps practices confirm insurance eligibility, review benefit information, identify authorization requirements, and coordinate requests with insurance payers.
By addressing potential coverage issues early, we help your team prepare for upcoming appointments with greater confidence and reduce preventable billing complications.
Verify coverage. Secure authorizations. Prepare with confidence.
Why Outsource Eligibility & Prior Authorization?
Insurance verification and authorization requirements can vary by payer, plan, and medical service. MedAxis MBS helps practices manage these responsibilities through organized verification and authorization workflows.
Verified Insurance Coverage
Confirm active coverage and review available insurance information before scheduled services.
Clear Benefit Information
Identify relevant copayments, deductibles, coinsurance, and other available benefit details.
Authorization Coordination
Determine when prior authorization may be required and help coordinate requests with payers.
Fewer Preventable Denials
Address eligibility discrepancies and authorization gaps that could affect claim processing.
Better Appointment Readiness
Help staff identify unresolved insurance requirements before scheduled visits or procedures.
Reduced Administrative Workload
Spend less time navigating payer portals, making verification calls, and tracking authorization requests.
A Proactive Approach to Insurance Verification
Effective eligibility and authorization management requires careful verification, timely communication, and consistent tracking. MedAxis MBS helps healthcare practices organize these essential tasks and address potential coverage obstacles before they disrupt operations.
Real Time Eligibility Checks: Verify coverage through available payer systems and verification channels.
Benefits Verification: Review available plan details, patient responsibility, and applicable coverage limitations.
Authorization Requirement Checks: Identify services that may require prior approval under payer policies.
Authorization Request Support: Coordinate submission of required clinical information and supporting documents.
Status Monitoring: Track pending requests and follow up on outstanding payer decisions.
Documentation Management: Maintain organized verification and authorization records to support billing workflows.
MedAxis MBS helps your practice prepare for services, reduce administrative uncertainty, and support a smoother patient financial experience.
Our Process, From Verification to Authorization
Our organized workflow helps healthcare practices check insurance details, manage authorization requirements, and keep important information accessible throughout the patient journey.
Patient & Insurance Information Collection
Gather patient demographics, insurance details, and relevant appointment or procedure information.
Eligibility Verification
Check available payer information to confirm coverage status and identify potential discrepancies.
Benefits & Requirements Review
Review available benefits, patient cost sharing, coverage limitations, and applicable authorization requirements.
Prior Authorization Preparation
Coordinate the required forms, clinical documentation, and supporting information for authorization requests.
Submission & Status Follow Up
Submit requests through available payer channels and monitor progress, including requests for additional information.
Outcome Documentation
Record verification findings and authorization decisions, and communicate unresolved requirements to the appropriate practice staff.
More Services
Denial management & appeals
Every denial worked, corrected and appealed until it is paid or closed.