Patient insurance eligibility verification is the beginning.

Rethink provides this important service—and perhaps most critical—as a step in the billing process. That means your front office does not need to obtain and accurately record all eligibility information. Rethink eligibility staff is responsible for determining each patient’s insurance eligibility, including: coinsurance or copay, deductible, benefits cap, where to send the claim, whether the payer requires specialized forms or additional documentation, and whether the payer requires authorization.

Next Steps

Authorization Service

Let our experienced staff help with the pre-certification (authorization) process for you.

Prior Authorization Process

The prior authorization process can cause more frustration among healthcare providers than any other administrative process. This is also one of the most important steps in getting paid for your services.

Pre-Authorization Services

Our pre-authorization services facilitate the pre-certification process between healthcare providers and their payers. Typically, pre-authorization services are required for most therapy services or any procedure that requires a pre-certification.

Rethink’s Pre-Certification Portal

The function of Rethink’s pre-certification portal is to collect patient information from medical providers to obtain prior authorization for required procedures.

Rethink Pre-Certification Services

Rethink Pre-Certification Services manages your pre-certifications from a centralized location, maximizing claim reimbursements with reliable and rapid turnaround time while reducing duplication and patient data errors.

Our experienced customer service staff communicate with the practice offices and insurance payers, ensuring pre-certification and approval requirements for your practice.

Determining Eligibility

Once Rethink receives the eligibility request and a copy of the insurance card (front & back), your account representative will submit it to our eligibility department. They will process your request and obtain as much information as possible about the benefits your patient has. Often conflicting information requires multiple calls to determine what the patient’s actual coverage is.

Once the eligibility is completed, you will receive an eligibility response form detailing all the information we obtained from the insurance company. This report will be returned to the practice within 2-5 business days (some carriers now allow 10 days to respond to eligibility verification requests.

A favorable benefits determination does not mean you will be paid by the insurance carrier.

Key Billing Features & Benefits

  • Dedicated team to obtain patient eligibility/benefits upon request
  • Understand patient eligibility & benefits prior to treating with full comprehensive benefit response
  • Reduce the risk of rejections/denials upfront with a quote of benefits for each patient you treat
  • Streamlined system saves both time and money
  • Free up your in-house resources
  • Fast turnaround time and increased customer satisfaction

Questions about our Billing Eligibility?

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