Practice Solutions, LLC

You just want to get paid for your incredible clinical work, but the insurance company seems to make the process impossible. You call a payer, verify that the patient's coverage is "active" (yes!), and submit the claim, only to have it come back months later as a dead-on-arrival (DOA) denial. The E&B (Eligibility and Benefits) check should never be skipped, but simply confirming coverage is "active" is not enough. This crucial step is not a simple light switch, and relying on just the active...

You spend precious administrative hours verifying eligibility and benefits (E&B) for every new patient, only for a handful of those claims to come back denied anyway. It’s frustrating when you feel like you've checked all the boxes, yet revenue still slips through the cracks—it's the billing equivalent of a "check engine" light. Here’s the sobering reality, straight from our Billing Director, Kelley Sonnenberg: Eligibility and benefit checks are only about 70% accurate across the industry. An...

1. Introduction: Stop Wrestling with Denials and Surprises Is your practice tired of wrestling with insurance denials, deciphering EOBs, and watching your revenue slip through the cracks? You are not alone. Handling insurance can create headaches, sleepless nights, and anxiety when there are no processes established. However, mastering one area—Eligibility and Benefits (E&B) verification—is a crucial component  for preventing those costly, frustrating surprises for both you and your patients....