Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the difficulties related to eligibility reporting, and it’s understandable the reasons practices struggle with staying current and optimizing the tools available to them. I correlate it to taxes – tax accountants are paid to stay current with everything and thus maximize the return to each customer.
The identical can probably be said for physician eligibility verification. There are specialists you are able to outsource to, ultimately optimizing the process for your practice. For individuals who keep up with the eligibility in-house, don’t overlook proven methods. Adhere to these pointers to aid guarantee you obtain it right every time and lower the risk of insurance claim issues and optimize your revenue.
Top 5 Overlooked Methods Seen to Boost the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility each and every visit: New and existing patients should have their eligibility verified Every. Single. Visit. Quite often, practices tend not to re-verify existing patient information because it’s assumed their qualifying information will remain the same. Untrue. Change of employment, change of datalinkms.com: Datalink MS Medical Billing Solutions » Insurance Eligibility Verification, services and maximum benefits met can alter eligibility.
2) Assuring accurate and complete patient information: Mistakes can be made in data entry when someone is trying to get speedy in the interests of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification may cause a domino effect of issues. Triple checking the accuracy of the eligibility entries will look like it wastes time, nevertheless it will save time over time saving practice managers from unnecessary insurance provider calls and follow-up. Be sure that you possess the patient’s name spelling, birth date, policy number and relationship for the insured correct (just for example).
3) Choosing wisely when based on clearing houses: While clearing houses will offer quick access to eligibility information, they usually do not offer all necessary information to accurately verify a patient’s eligibility. Most of the time, a phone call designed to a representative in an insurance carrier is essential to collect all needed eligibility information.
4) Knowing exactly what the patient owes before they even can arrive at the appointment: You should know and be ready to advise a patient on the exact amount they owe to get a visit before they can arrive at the office. This may save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the aid of credit bureaus to collect on balances owed.
5) Possessing a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will certainly be a major help. Not every specialties are similar, nor could they be treated the identical by insurance carrier requirements and coverage for claims and billing.
Since we said, it’s practically impossible for all practice operations to operate smoothly. There are inevitable pitfalls and areas susceptible to issues. You should establish a defined workflow plan that includes combination of technology and outsourcing if required to achieve consistency and accountability.
Insurance verification and insurance authorization is the process of validating the patient’s insurance details and obtaining assurance by calling the insurance payer or through online verification. The process ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, type of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum and more.
Datalinkms is really 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 begins with retrieving a summary of scheduled appointments and verifying insurance policy coverage for your patients. When the verification is done the policy details are put directly into the appointment scheduler for your office staff’s notification.