+1 (307) 209-2667
info@hhsbilling.com
30 N Gould St Ste R, Sheridan, WY 82801, USA
Medical Eligibility & Benefits Verification
Ensure Clean Claims with Accurate Eligibility & Benefits Verification
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Verify coverage before services are rendered
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Eliminate billing surprises and reduce denials
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Improve front-desk efficiency and reduce admin burden
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Enhance patient satisfaction with cost clarity
Contact US
What We Do:
Check patient insurance eligibility in real-time
Verify copays, deductibles, and policy limitations
Identify Coordination Of Benefits (COB) issues
Detect plan changes and insurance expirations
Provide summarized verification for provider clarity
Detailed Tasks We Perform for Seamless Verification
We validate insurance coverage and active policy status prior to every visit to ensure services are billable.
Our team gathers and reviews details on co-pays, deductibles, visit limits, exclusions, and authorizations.
We proactively check COB status to avoid primary/secondary insurance mix-ups that delay reimbursement.
We verify if the patient’s policy covers the provider's intended services or specialty-specific procedures.
We detect terminated or expired policies ahead of time, helping avoid claim rejections.
Out-of-pocket estimates are calculated based on benefits data, helping improve patient transparency.
Optimize Claims, Reduce Denials, and Improve Front-Office Accuracy
Effective billing starts with complete, accurate eligibility verification. At Horizon Healthcare Solutions, we streamline this critical step by conducting in-depth checks across major payers. Our team ensures that your staff has full clarity on each patient’s active coverage before the appointment.
By providing a thorough breakdown of patient benefits, copays, deductibles, and policy limitations, we help minimize errors in claims and improve payment timelines. Our verification process includes detecting COB conflicts, plan terminations, and services requiring prior authorization.
Whether you’re managing high patient volume or handling complex payer policies, our systemized verification approach improves workflow efficiency and protects your revenue cycle from claim denials due to incomplete or inaccurate insurance data.
Common Challenges in Eligibility & Benefits Verification
01
Incomplete or Outdated Insurance Information
Patients often provide old insurance cards or outdated plan details, leading to denied claims if not caught early.
02
Lack of Coordination of Benefits (COB) Clarity
Without verifying which payer is primary, claims can be incorrectly billed and delayed by weeks or months.
03
Hidden Coverage Limitations
Certain plans have restrictions on visit counts, specific CPTs, or provider types that can lead to surprise denials.
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Missed Insurance Termination Notices
Unnoticed plan terminations are a common cause of denials when coverage has ended without your team knowing.
05
Errors in Patient Responsibility Estimates
If deductibles or copays are not calculated accurately, patients may be over- or under-charged, hurting trust and collections.
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Front Desk Bottlenecks
Manual verification or missing payer logins slow down your front office, increasing admin burden and patient wait times.
Accurate Verification is the Foundation of Successful Billing
At Horizon Healthcare Solutions, we help you reduce your claim rejections by making eligibility and benefit verification bulletproof. Our proactive checks save time for your team and eliminate errors caused by outdated insurance details or unverified benefits.
We tailor our process to match your specialty and payer mix, ensuring high accuracy, fewer reworks, and a faster path to clean claims. Whether it’s handling COB issues or identifying coverage gaps, we flag problems before they impact your billing.
By partnering with us, your practice gains more control over collections, fewer denials, and enhanced patient satisfaction — all without adding stress to your front-office staff.
How We Add Value to Your Practice
Redefining Industry Excellence
HIPAA Compliant
Our commitment to HIPAA compliance ensures the highest standards of data security and patient confidentiality. We implement robust safeguards to protect sensitive information, allowing healthcare providers to focus on delivering exceptional patient care.
Proven Results and Cost Efficiency
Customized, Client-Centric Approach
Committed to Your Success
Comprehensive Claims Reviews
Regularly conducted assessments of denied claims to pinpoint submission errors and enhance future claim accuracy.
Ease and Simplicity
Our services integrate with your existing software and in-house team to ensure efficient and profit-focused processes.
Reliable Support, When You Need It
Our dedicated team is available to assist you during convenient hours and ensures prompt responses to your inquiries by phone, email or chat.
