Patient Appointment Management
At Avenida Health Services, we understand that efficient patient scheduling and appointment management is essential to providing high-quality healthcare. That's why we offer a comprehensive suite of services to help our clients streamline their scheduling processes, improve patient satisfaction, and reduce no-shows.
Eligibility and Benefits verification
We deliver fast, accurate eligibility and benefits verification to ensure providers have complete financial clarity before services are rendered. Our team verifies coverage details, copays, deductibles, prior authorization requirements, and plan limitations—reducing claim denials and accelerating reimbursement. With real-time updates and proactive communication, we help practices streamline patient intake, minimize financial surprises, and enhance the overall care experience.
Prior Authorization
Avenida Health Services specializes in offering comprehensive drug prior authorization services for Medicare and Medicaid plans of US patients. Our team of experienced professionals, including PharmDs, has expertise in both electronic and paper prior authorization (PA) processes. We excel in answering clinical queries and fetching clinical data from patients’ Electronic Health Records (EHR). We have a proven track record of dealing with PA rejections and appeals to ensure claim approvals. By leveraging our expertise, we provide clinical justifications for drugs in a timely manner, resulting in higher claim approval rates.
Claims adjudication
Avenida Health Services offers end-to-end billing solutions to various healthcare entities, including long-term care pharmacies, retail pharmacies, Our expertise lies in claim adjudication, claim denial management, and data entry. We assist in generating DEA letters for narcotic prescriptions, ensuring compliance and adherence to regulatory requirements. By outsourcing billing processes to us, healthcare organizations can significantly reduce operational costs by up to 70% while maintaining accuracy and efficiency.
Pharmacy call support
We provide exemplary customer service support to pharmacies, US facilities, MD offices, and long-term care facilities. Our team efficiently handles prescription errors, communicates drug availability and alternatives, and addresses drug-related queries. Additionally, we review pharmacy inventory reports to identify duplicate orders and monitor OTC medication billing reports. By outsourcing customer service tasks to us, healthcare organizations can enhance their service levels, improve patient satisfaction, and reduce operational costs..
Pharmacy data entry
Our data entry services cater to pharmacies, hospitals, MD offices, and insurance companies, with a focus on prescription data entry and coding using ICD/CPT codes. Our team of trained professionals ensures accurate and timely data entry to streamline operations and facilitate smooth reimbursement processes. By outsourcing data entry tasks to us, healthcare organizations can minimize administrative burdens, improve efficiency, and redirect resources towards core healthcare functions.,