Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the issues associated with eligibility reporting, and it is understandable why many practices have a problem with staying current and optimizing the equipment available to them. I correlate it to taxes – tax accountants are paid to stay current with everything and therefore maximize the return to each customer.
Exactly the same can probably be said for medical insurance eligibility verification. You will find specialists you are able to outsource to, ultimately optimizing the process for that practice. For those who maintain the eligibility in-house, don’t overlook proven methods. Abide by these tips to aid guarantee you obtain it right each and every time and reduce the potential risk of insurance claim issues and improve your revenue.
Top 5 Overlooked Methods Shown to Raise the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility each visit: New and existing patients needs to have their eligibility verified Every. Single. Visit. Quite often, practices usually do not re-verify existing patient information because it’s assumed their qualifying information will remain the same. Not the case. Change of employment, change of insurance coverage or company, services and maximum benefits met can alter eligibility.
2) Assuring accurate and finish patient information: Mistakes can be made in data entry when someone is wanting to get speedy in the interests of efficiency. Including the slightest inaccuracy in patient information submitted for eligibility verification may cause a domino effect of issues. Triple checking the accuracy of your own eligibility entries will appear to be it wastes time, but it will save time over time saving practice managers from unnecessary insurance provider calls and follow-up. Ensure that you have the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just for example).
3) Choosing wisely when according to clearing houses: While clearing houses will offer quick access to eligibility information, they usually usually do not offer all necessary information to accurately verify a patient’s eligibility. More often than not, a call made to an agent at an insurance company is important to assemble all needed eligibility information.
4) Knowing exactly what the patient owes before they even can get through to the appointment: You need to know and be ready to advise the patient on the exact amount they owe for any visit before they even can arrive at the office. This can save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the help of cgigcm bureaus to accumulate on balances owed.
5) Possessing a verification template specific to the office’s/physician’s specialty. Defined and particular questions for coverage pertaining to your specialty of practice will certainly be a major help. Not all specialties are the same, nor will they be treated the same by insurance company requirements and coverage for claims and billing.
As we said, it’s practically impossible for many practice operations to operate smoothly. There are inevitable pitfalls and areas prone to issues. It is essential to begin a defined workflow plan that also includes mixture of technology and outsourcing if needed to achieve consistency and accountability.
We have been a healthcare services company providing outsourcing and back-office solutions for medical billing companies, medical offices, hospital billing departments, and hospital medical records departments. Our company offers Eligibility Verification to prevent insurance claim denials. Our service starts off with retrieving a summary of scheduled appointments and verifying insurance coverage for the patients. Once the verification is done the coverage facts are put into the appointment scheduler for the office staff’s notification.