How is eligibility status checked during the Resolute billing process?

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Multiple Choice

How is eligibility status checked during the Resolute billing process?

Eligibility status is checked through real-time or batch verification as part of the Resolute billing workflow. Real-time verification happens at the point of service, confirming that the patient has active coverage and that the planned services are covered, along with known patient financial responsibilities. Batch verification runs on a schedule to review eligibility for groups of patients before claims are submitted, catching changes in coverage or benefits that could affect billing. This approach helps ensure services are billable and reduces denials by catching eligibility issues before claims are sent. Manual review after submission is slower and riskier, checking only at check-in can miss subsequent changes, and saying eligibility isn’t checked would remove a key control that protects reimbursement.

Eligibility status is checked through real-time or batch verification as part of the Resolute billing workflow. Real-time verification happens at the point of service, confirming that the patient has active coverage and that the planned services are covered, along with known patient financial responsibilities. Batch verification runs on a schedule to review eligibility for groups of patients before claims are submitted, catching changes in coverage or benefits that could affect billing. This approach helps ensure services are billable and reduces denials by catching eligibility issues before claims are sent. Manual review after submission is slower and riskier, checking only at check-in can miss subsequent changes, and saying eligibility isn’t checked would remove a key control that protects reimbursement.

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