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Advance Benefits Verification

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Real-Time Insurance Eligibility & Advance Benefits Verification

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One of the most preventable — yet most common — causes of claim denials and unexpected patient balances is the failure to verify insurance benefits before the appointment. At Carewell Healthcare Solutions, our Advance Benefits Verification (ABV) service confirms every patient’s active coverage, plan details, and out-of-pocket responsibilities before they walk through your door.

By proactively verifying eligibility and benefits for every scheduled visit, we eliminate coverage surprises, reduce post-service denials, and ensure your front office has all the financial information needed to collect accurately at the time of service — protecting your revenue from day one of the patient encounter.

The True Cost of Skipping Benefits Verification

Many practices discover too late that a patient’s coverage lapsed, a service required prior authorization, or the patient had met their out-of-pocket maximum — all issues that proper advance verification would have caught. These oversights result in denied claims, delayed payments, and frustrated patients who receive unexpected bills after their visit.

Preventive benefits verification is the foundation of a healthy revenue cycle. When your team knows exactly what is covered, what the patient owes, and what requires authorization before the appointment, your entire billing process becomes smoother, faster, and more predictable.

What We Offer

Real-Time Eligibility Verification

Active coverage status, plan type, effective dates, and group/policy numbers confirmed for every patient before their scheduled appointment.

Deductible & Co-Pay Confirmation

Patient out-of-pocket responsibilities  deductibles, co-pays, co-insurance amounts, and remaining out-of-pocket maximums  verified so your team can collect accurately upfront.

 
Prior Authorization Identification

We identify all services requiring prior authorization and initiate the authorization request in advance, preventing costly after-the-fact denials for non-authorized care.

Secondary Insurance Coordination

Verification of secondary and tertiary payer coverage for patients with dual insurance, ensuring correct coordination of benefits and billing order to maximize collection.

 
Service-Specific Benefit Confirmation

We confirm coverage for specific procedures and service types before they are performed, dramatically reducing denials for non-covered services.

Verification Summary Reports

Daily verification summaries delivered to your front office team, giving them everything they need to prepare for each patient visit and collect appropriately.

Eliminate Coverage Surprises Verify Before Every Visit

Let our team handle benefits verification so your front office can focus on patients.