#MBW RCM Solutions

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MBW RCM Patient Access: Insurance Verification & Prior Authorization

Efficient patient access is the cornerstone of a successful revenue cycle. At MBW RCM, we understand that the first step in the revenue cycle — verifying insurance and obtaining prior authorizations — can determine the speed and accuracy of reimbursement. Our Patient Access Solutions are designed to minimize claim denials, reduce administrative burden, and create a seamless experience for patients and providers alike.

1. Why Patient Access Matters in Revenue Cycle Management

Patient access is more than just registration. It includes every process that occurs before a patient visit or procedure, directly affecting revenue integrity. When insurance verification or prior authorization is missed, delays, rework, and denied claims become common, impacting both cash flow and patient satisfaction.

2. Comprehensive Insurance Verification Services

MBW RCM offers end-to-end insurance eligibility verification services that check a patient’s coverage, copays, deductibles, and policy limitations in real-time. By integrating advanced tools and payer-specific protocols, we help clients avoid delays and improve clean claim rates from the start.

Explore more on our Revenue Cycle Mid-Cycle Services that complement patient access functions.

3. Streamlined Prior Authorization Management

Obtaining prior authorization can be time-consuming and complex, especially for high-cost procedures. Our team of trained professionals works with all major payers to ensure the right documents and clinical codes are submitted upfront. We track every authorization status and follow up aggressively to meet procedure timelines.

4. Specialty-Focused Authorization Expertise

Whether you’re a cardiologist, oncologist, or OB/GYN specialist, MBW tailors its prior authorization process based on your specialty’s coding patterns and payer rules. This specialization helps reduce denials related to medical necessity and improves overall RCM efficiency.

5. Technology-Enabled Pre-Visit Workflow Automation

We incorporate robotic process automation (RPA) and AI tools to verify benefits, validate referrals, and even flag pre-certification issues. This reduces manual effort, shortens turnaround times, and increases throughput, especially in hospital and urgent care environments.

6. Real Results: Case Studies That Prove the ROI

One of our multi-specialty clients saw a 40% reduction in prior auth denials within 60 days of onboarding. In another case, eligibility errors dropped to under 2% — all thanks to MBW’s proactive patient access protocols. These real-world improvements reflect our commitment to measurable impact.

Improving patient access with robust insurance verification and prior authorization services isn’t just about administrative accuracy — it’s about protecting revenue and delivering a better patient experience. MBW RCM helps healthcare providers take control of this critical first step in the revenue cycle.

Discover how our full suite of Patient Access Services can support your revenue goals. Or connect with us to learn more about specialty-specific RCM solutions tailored to your practice.