Eligibility and Benefits Verification Services
Verify insurance coverage in real-time to reduce denials and secure faster payments.
Optimize Revenue with Pre-Service Eligibility Checks
Inaccurate or missing insurance information is one of the top reasons for denied or delayed claims. At Ardur Healthcare, our eligibility and benefits verification services help eliminate those problems before they occur. Whether you're verifying Medicaid, Medicare, or commercial plans, we ensure you have the information needed to bill correctly and get paid faster. Here's what our eligibility and benefits verification service includes:
Coverage Confirmation: Real-time insurance eligibility verification for Medicare, Medicaid, and commercial payers.
Benefit Details: Detailed summaries of co-pays, coinsurance, deductibles, and out-of-pocket max.
Authorization Checks: Identification of services that require prior authorization.
Plan Limitations: Review of service-specific coverage limitations (e.g., therapy visit caps).
Insurance Gaps: Early detection of inactive coverage or termination before care is rendered.
Our Eligibility Verification Process
We follow a rigorous, standardized workflow to ensure no detail is missed during verification:
Data Capture: Collect insurance details from your EMR/scheduling system or intake forms.
Primary Source Verification: Cross-check eligibility via payer portals, EDI, and direct insurer calls.
Documentation: Provide a structured, easy-to-read benefits breakdown for your front desk and billing team.
Flagging Requirements: Highlight pre-authorization needs and missing data points.
Daily Reports: Deliver eligibility reports before each day's appointments so your staff can stay ahead.
Why Choose Ardur Healthcare for Benefits Verification?
Specialty-Tailored Checks: We adapt our process to your specialty, mental health, ortho, physical therapy, etc.
Medicaid & Medicare Experts: From verifying Medicaid eligibility to navigating Medicare rules, we've got it covered.
Custom Reporting: Daily and weekly verification summaries customized to your operations.
Claim-Ready Data: We ensure your billing team receives clean, coded coverage info they can act on.
Compliance Guaranteed: Fully HIPAA-compliant workflows and secure access protocols.
Ready to Eliminate Coverage Guesswork?
Let our experts handle your insurance verification so your team can focus on care, not paperwork.
Start Verification ServicesFrequently Asked Questions
Everything you need to know about our Eligibility and Benefits Verification Services.
It's the process of confirming a patient's insurance coverage, plan details, and prior authorization needs before rendering services to reduce denials and delays.
Yes. We verify Medicaid coverage across all states, including state-specific plans and Medicaid Managed Care programs.
We deliver eligibility reports ahead of patient appointments, usually at least 24 hours in advance, so your front desk and billing team are fully prepared.
Absolutely. We verify benefits for all Medicare Advantage plans and identify any service restrictions or referral needs.
Basic patient demographics, insurance ID, and scheduled service details. We can pull this directly from your EHR or intake forms.
Ready to Optimize Your Revenue Cycle?
Stop letting claim denials and administrative burdens slow you down. Partner with Ardur Healthcare and focus on what matters most—patient care.