Toll Free number: 888-988-0605 Providers can now submit Claims EDI files directly for all Health Plans (EDI Payer list) Register here and start submitting right away Contact Us to set up Payment Remittance processing from the Health Plan Toll Free number: 888-988-0605 Providers can now submit Claims EDI files directly for all Health Plans (EDI Payer list) Register here and start submitting right away Contact Us to set up Payment Remittance processing from the Health Plan

Insurance eligibility and benefits verification solutions for accurate reimbursements

PCH Health ensures healthcare providers receive timely and accurate insurance coverage processing. Our dedicated insurance eligibility and benefits verification team works diligently to minimize providers’ aging days and maximize revenue.

With over thirty years of experience in the Electronic Health Record (EHR) market, PCH Health has established strong payer relationships and tailored our eligibility services to meet the changing needs of our valued clients perfectly.

Patient schedule integration icon

Patient schedule integration

Efficiently plan verification processes upon receiving patient schedules from healthcare providers.

Accurate demographic information entry icon

Accurate demographic information entry

Ensure precise entry of patient demographics to verify eligibility and benefits.

Thorough coverage & benefits analysis icon

Thorough coverage & benefits analysis

Determine service coverage while managing third-party and dual eligibility, and out-of-state verifications.

System updates with payer details icon

System updates with payer details

Update revenue cycle systems with accurate payer details post-verification.

Why outsource eligibility and benefits verification services?

PCH Health empowers your staff to prioritize patient care by streamlining operations and eliminating claim errors. Our experts seamlessly address your eligibility and benefits verification needs, improving the patient experience.

We excel at handling inconsistent data and navigating the complexities of insurance systems. From verifying copays and deductibles to assessing insurance policies and coverage limitations, our team ensures accuracy at every step.

Our partners have experienced reduced call volumes, staffing challenges, and inaccuracies, resulting in enhanced patient satisfaction and fewer payment delays. Want to learn more?

Results-driven eligibility and benefits verification solutions

Reduce denials and improve financial performance with PCH Health:

98%

Increase in net collection

72%

Boost in productivity

36%

Decrease in A/R

45%

Reduction in cost

Benefits of our eligibility and benefits verification services

  • Collect actual payments from patients during visits
  • Understand services covered by patient plans
  • Enhance patient satisfaction and physician utilization
  • Decrease staff workload, delays, and errors

Certifications & Awards

Our awards highlight our commitment to excellence, innovation, and delivering impactful solutions that drive positive results for our clients and the patients in their care.

idc icon

Major Player

IDC MarketSpace U.S.RCM Service Solutions, 2022-2023

nelsonhall-Neat-Leader icon

NelsonHall

NelsonHall’s Healthcare Payer Operational Transformation NEAT Vendor Evaluation 2023

Medical Coding Operations icon

Everest Peak Matrix

PEAK Matrix® for Medical Coding Operations 2022

PEAK Matrix® for Intelligent Automation Healthcare 2022 icon

Everest Peak Matrix

PEAK Matrix® for Intelligent Automation Healthcare 2022

HI TRUST CSF Certification icon

HI TRUST CSF Certification

PCI DSS Certified icon

PCI DSS Certified

Veracode Verified Attestation icon

Veracode Verified Attestation

Top specialties managed by PCH Health include but are not limited to:

Ambulatory Surgical Center icon

Ambulatory Surgical Center

Behavioral Health icon

Behavioral Health

Cardiology icon

Cardiology

Oncology icon

Oncology

Orthopedics icon

Orthopedics

Primary Care icon

Primary Care

Urgent Care icon

Urgent Care

Get Started With Your Account


Or