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Eligibility & Authorization

Eligibility and Authorization Support Before Claims Are Submitted

Eligibility and authorization issues can delay billing or put payment at risk before a claim is submitted.

The Problem

Where Coverage Gaps Put a Claim at Risk

Eligibility Changes After Scheduling

Coverage can change between when a service is scheduled and when it's delivered, putting the claim at risk.

Authorization Information That Is Missing or Outdated

Missing, expired, or incomplete authorization information can prevent a claim from being ready for submission.

Authorization Requirements That Vary by Payer

Requirements for prior authorization differ by payer and program, so a process that works for one claim may not apply to the next.

What's Included

  • Eligibility review at intake, with scheduled reverification
  • Authorization intake and reverification
  • Coordination with payer-specific requirements
  • Available standalone or as part of broader billing support
How We Handle It

A Pre-Billing Check Before Claim Submission

Walters reviews available eligibility and authorization information before claims are submitted, helping agencies identify missing or unresolved items that may create a billing delay or denial.

This service is available on its own for agencies that manage billing in-house, or as part of Walters' broader revenue cycle support.

Best Fit

Agencies that need pre-billing support identifying missing, expired, or unresolved eligibility and authorization information.

Metrics Commonly Monitored
  • Pre-billing hold volume
  • Authorization-related denial rate
  • Clean claim rate

Looking for a Billing Team That Works Like Part of Yours?

Tell us about your agency, current billing operation, and what you want to improve. An experienced billing specialist—not a sales representative—will follow up to discuss your needs and determine the appropriate next step.

Talk With a Billing Specialist