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Eligibility & Benefits Verification

Verify First.
Get Paid Every Time. Get Paid Every Time. Get Paid Every Time.

RMBServ verifies every patient’s insurance eligibility and benefits before services are rendered eliminating claim rejections at the source and ensuring your practice receives payment every single time.
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650-240-0061
HIPAA Certified
US-Based Team
No Hidden Fees
24/7 Support
98% Eligibility Accuracy

98%

Eligibility Accuracy Rate
↑ Above industry avg

24hr

Avg Verification Turnaround
↓ Faster than average

99.9%

Claim Acceptance Rate
↑ First-pass rate

3.99%

Flat Rate Collections Only
✓ No hidden fees

What We Handle For You

  • Insurance Eligibility Checks
Real Time
  • Benefits & Coverage Verification
Included
  • Prior Authorization Support
Included
  • Co-Pay & Deductible Review
Every Patient
  • Detailed Verification Reports
Full Detail

About This Service

What is Eligibility &
 Benefits Verification? Benefits Verification? Benefits Verification?

Eligibility and benefits verification is the process of confirming a patient’s active insurance coverage, plan details, co pays, deductibles, and covered services before any healthcare service is rendered.
Without proper verification, practices routinely submit claims that get rejected not because the service wasn’t provided, but because the patient’s coverage had lapsed, the service wasn’t covered, or the wrong payer was billed. These are entirely preventable errors.
RMBServ verifies every patient’s insurance eligibility and benefits prior to each visit. Our specialists contact payers directly, confirm active coverage, identify co-pays and deductibles, and flag any authorization requirements giving your front desk and billing team complete, accurate information before the patient even sits down.
The result: fewer rejections, faster payments, and zero surprises for you or your patients.

30%

Avg claim rejections due to eligibility errors at most practices

98%

RMBServ eligibility accuracy rate above industry standard

24hr

Average turnaround for verification results

27+

Medical specialties covered across all 50 states

Insurance Eligibility Verification

  • Active coverage confirmation with payer
  • Policy effective and termination dates
  • Primary & secondary insurance identification
  • Plan type verification (HMO, PPO, EPO)
  • In-network vs out-of-network status check

Benefits & Coverage Verification

  • Co-pay and co-insurance amounts
  • Deductible status and amounts remaining
  • Out-of-pocket maximum verification
  • Covered services and procedure confirmation
  • Referral and prior authorization requirements

Prior Authorization Support

  • Authorization requirement identification
  • Prior auth request submission to payer
  • Status tracking and follow-up
  • Documentation preparation and support
  • Urgent authorization escalation when needed

Core Services Included

Everything Covered
 Every Patient, Every Visit Every Patient, Every Visit Every Patient, Every Visit

From patient scheduling to claim submission – every step handled so your claims go out clean and get paid fast.

Real Time Eligibility Checks

We verify active insurance coverage in real-time through direct payer contact and electronic portals confirming every patient before services are rendered.

Co-Pay & Deductible Review

We confirm exact co-pay amounts, deductible balances, and out of pocket maximums so your front desk can collect accurately at the point of service every time.

Prior Authorization Management

We identify which services require prior authorization, submit requests to payers, track approvals, and ensure no claim is ever submitted without required authorization.

Secondary Insurance Coordination

We identify and verify secondary insurance coverage, confirm coordination of benefits order, and ensure claims are submitted correctly to all applicable payers.

Detailed Verification Reports

You receive complete verification reports for every patient including coverage details, benefits breakdown, auth status, and any flags requiring your attention.

Denial Prevention & Follow-Up

Any eligibility related denials that do occur are immediately analyzed, corrected, and resubmitted with process improvements to prevent the same issue recurring.

Step by Step

Our Complete Verification Verification Verification Process

Comprehensive verification services that eliminate eligibility related rejections before they happen.
Step 1

Patient Scheduling & Insurance Intake

When a patient appointment is scheduled, we collect all insurance information - carrier name, member ID, group number, and subscriber details. We flag any missing or incomplete information immediately so it can be resolved before the appointment date.
Insurance Intake Data Collection Missing Info Flags

Step 2

Real Time Eligibility Verification

We verify every patient's active insurance coverage directly with the payer confirming policy status, effective dates, plan type, and in-network participation. We check primary and secondary insurance simultaneously to ensure complete coverage clarity.
Active Coverage Policy Dates Network Status

Step 3

Benefits & Coverage Confirmation

We confirm exactly what is covered under the patient's plan specific procedure coverage, co-pay and co-insurance amounts, deductible balances, and out-of-pocket maximums. This gives your team accurate financial information before the patient arrives.
Co-Pay Amounts Deductible Status Covered Services

Step 4

Prior Authorization Check & Submission

We identify whether any planned services require prior authorization and immediately initiate the request process. We prepare and submit all required documentation to the payer, track approval status, and escalate urgently when timelines are tight.
Auth Requirements Request Submission Approval Tracking

Step 5

Verification Report Delivery

A complete verification report is delivered to your billing and front desk team before the patient appointment covering coverage status, benefits breakdown, co-pay amounts, authorization status, and any flags requiring attention or follow-up.
Full Report Pre-Visit Delivery Action Flags

Step 6

Post-Service Denial Prevention Follow-Up

If any eligibility-related claim rejection does occur, we immediately investigate, correct the issue, and resubmit. We also analyze root causes and update our verification process to prevent the same error from occurring again for future patients.
Denial Analysis Correction & Resubmit Process Improvement

24 Hour Turnaround

Verifications completed within 24 hours of scheduling

15+ Software Compatible

Works with Epic, Kareo, AdvancedMD, eClinicalWorks & more

HIPAA Secure

Full HIPAA compliance on every verification and communication

Dedicated Specialists

Your own verification team always available and accountable

Why Choose RMBServ

Verification That Eliminates
 Rejections Before They Happen Rejections Before They Happen Rejections Before They Happen

Top Reason - Stop Losing Revenue to Preventable Rejections

Up to 30% of claim rejections are caused by eligibility errors that could have been caught before the patient was ever seen.

RMBServ verifies every patient before every visit catching lapsed coverage, missing authorizations, and billing errors before they become denied claims. Our 98% accuracy rate and 24-hour turnaround mean your practice is always billing with complete, verified information.
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Accuracy Rate

0 hr

Turnaround

0 +

Specialties

0 /7

Always available

98% Accuracy Rate

Our meticulous verification process achieves 98% accuracy virtually eliminating eligibility related claim rejections and ensuring your claims go out clean every time.

24 Hour Turnaround

We deliver complete verification results within 24 hours of scheduling giving your team accurate coverage and benefits information well before the patient arrives.

Prior Auth Managed End-to-End

We identify, submit, track, and confirm all prior authorization requirements so no claim is ever denied for missing or expired authorization.

Accurate Point-of-Service Collections

With verified co-pay and deductible information delivered before every visit, your front desk can collect accurate patient balances at the time of service.

HIPAA Certified & Secure

All patient insurance data and verification communications are handled with strict HIPAA compliance. Your patients' information is protected at every step.

Dedicated Support Team

Our dedicated verification specialists are knowledgeable, responsive, and always ready to support your practice available 24/7 whenever you need them.

Software Compatibility

We Work With Your Existing Software Existing Software Existing Software

No need to switch platforms. We are experienced with 15+ leading medical billing and practice management systems.
AdvancedMD
Epic
Kareo
eClinicalWorks
AthenaCollector
NextGen
Brightree
Medisoft
Practice Fusion
Allscripts PM
NueMD
Vericle
ChiroTouch
Centricity
HealthFusion
Office Ally
Prompt EHR
Tebra
Get Started Today

Stop Losing Revenue to
Preventable Eligibility Errors Eligibility Errors Eligibility Errors

Let our certified verification specialists confirm every patient’s coverage before every visit eliminating rejections at the source and ensuring you get paid every time.
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Email Us Today

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Call Us Directly

650-240-0061

Email Us

business@rmbserv.com

HIPAA Certified
US-Based Team
Only 3.99% Flat Rate
24/7 Support
1 - 4 Week Onboarding
No Hidden Fees
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