Benefits Analysis

The AVA Benefit Analysis

Most billing companies provide a basic verification of benefits.

AVA Billing takes things one step further, by providing a full benefit analysis.

A basic description of coverage gives the facility an idea of what to expect in terms of reimbursement. Preliminary information obtained includes member responsibility, maximums, and plan specific information regarding coverage.

AVA Billing knows the benefit of giving providers a more complete idea of what coverage will look like. We utilize our database of provider knowledge and plan-specific payment history to give you a realistic idea of what to expect if your client admits.

Part I: VERIFICATION OF BENEFITS

AVA Verification Specialists will provide the facility with the following information:

• Patient policy deductible and out-of-pocket responsibility (Member Responsibility)
• Co-insurance and administrative co-payments
• Benefit limits and policy maximums
• Reimbursement estimates
• Pre-authorization and clinical requirements for admissions

Part II: MEDICAL NECESSITY ANALYSIS

AVA takes it a step further than other billing companies by providing an estimate of authorization potential based on a brief clinical snapshot provided by your facility. Using the information gathered, we can more accurately gauge the actual return from a carrier for a client that you have admitted.