Insurance Verification & Precertification

Insurance Verification & Precertification

Part of our process includes helping you minimize claim denials and properly assess your patient’s financial responsibility by verifying patients' insurance eligibility and benefits to ensure you get paid...

The details below will help you understand how we can help!

Are Your Claims Being Denied Due to Bad Information?

Accurate insurance verification is essential, especially for hospital-based providers who rely on third-party patient data. Sentrii employs specialized processes to validate and correct insurance information received from all clients, minimizing claim denials. Additionally, we assess self-pay patients for alternative coverage sources, maximizing overall reimbursement potential...

Sentrii’s Insurance Verification & Precertification Process will help you minimize claim denials and properly assess your patient’s financial responsibility by verifying patients' insurance eligibility and benefits.

We Will Provide Your Practice the Following Services

Our Insurance Verification Process

  • Confirm a patient's insurance policy details
  • Validate that the policy is active
  • Determine what is covered by the policy
  • Update the patient record with verified insurance details

Our Precertification Process

  • Obtain approvals from an insurance company that a treatment is medically necessary
  • Ensure patients receive the necessary medical care
  • Verifiy the medical necessity and coverage for the proposed treatment
  • Avoid unnecessary denials and delays

How The Process Works

  • Insurance verification specialists will call the insurance carrier or visit payer web portals
  • Insurance authorization companies handle prior authorizations via phone or web portals
  • Prior authorization requests risk being rejected due to errors or missing information
Without prior authorization, the health plan may not cover the treatment. Our insurance verification & precertification process confirms a patient's insurance coverage and benefits while also getting approval from an insurance company for a specific treatment.

Benefits of Our Insurance Verification & Precertification Services

Maximized Reimbursements

By evaluating self-pay patients for alternative coverage options, your practices’ reimbursement potential can increase and ensure no revenue is lost

Reduced Denial Rates

Verifying insurance information upfront significantly lowers your chances of claim denials due to coverage issues or inaccuracies in patient data

Informed Decision Making

Knowing a patient’s coverage helps you to make the right decisions about treatment options and lets them receive care without the financial burden

What's the NEXT STEP once you address any issues you have with your current Insurance Verification & Precertification Process?

When you work with our team to streamline every aspect of your Revenue Cycle Management (RCM) Process to ensure that you are maximizing revenue, reducing inefficiencies, and eliminating costly errors, your practice will benefit in a magnitude of ways! Our proven process includes 12 key steps within the medical billing lifecycle that our team can help you implement or manage on your behalf - let's connect and discuss your options TODAY!

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Here are Some Frequently Asked Questions Our Staff Gets...

Is there a long-term contract?

We offer a 90-day termination clause in all our contracts, allowing flexibility for our clients. While the traditional approach was to use long-term contracts to cover ramp-up costs, we now structure those costs based on the specific work needed, eliminating the need for long-term commitments

How soon can I get started?

If there are no termination clauses to navigate and you can facilitate administrative control, we can get started right away. Our team is prepared to ensure a smooth transition with minimal disruption to your operations

Is it painful to transition to a new billing company?

Transitioning to a new billing company can be challenging, but a lockbox can help streamline the process by consolidating payments from multiple sources into a single location. While there may still be some initial setup and coordination required, using a lockbox minimizes payment disruptions and simplifies cash flow management, making the transition smoother and less painful. Proper planning and communication with payers can further reduce potential issues

How long will it take for me to see improvements?

Our reports are reliable, but the timeline for seeing improvements depends on several factors, including the quality of prior data and the specific changes implemented. While an apples-to-apples comparison is ideal, we often inherit incomplete or inconsistent data, requiring time to normalize and establish accurate benchmarks. Typically, meaningful trends become apparent within a few billing cycles

Can you work with my current staff?

We always strive to incorporate existing staff whenever possible, as long as they are willing and able to contribute effectively. We understand that external billing vendors can sometimes be met with hesitation, but our goal is to work collaboratively and ensure a smooth process while valuing the expertise already in place. Finding good talent is challenging, so we’re happy to work with your current staff to maximize efficiency and success

How much do you charge?

Our pricing is typically based on a percentage of collections, which varies depending on your practice's volume and specialty. Patient billing, including mailed statements, text, and email bills, is charged separately at cost, with digital options often being more affordable. Provider credentialing and enrollment are offered à la carte, and we also provide a wide range of optional services, from appointment reminders and eligibility checks to consulting and utilization reviews. For smaller practices, we have a minimum fee designed to be affordable. Let’s discuss your specific needs so we can provide a tailored quote

Still have questions about Insurance Verification & Precertification? Pick up the phone and give us a call @ 440-226-6837; we have the answers you need!

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By  Casey Stillman    On 14 February 2025
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Test Blog Post #2

By  Casey Stillman    On 14 February 2025
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