Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the problems related to eligibility reporting, and it’s understandable why many 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.
Exactly the same can be stated for physician eligibility verification. You can find specialists you can outsource to, ultimately optimizing the procedure for your practice. For those who maintain the eligibility in-house, don’t overlook proven methods. Comply with these pointers to aid assure you get it right every time and reduce the risk of insurance claim issues and optimize your revenue.
Top 5 Overlooked Methods Seen to Raise the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility each and every visit: New and existing patients must have their eligibility verified Every. Single. Visit. Very often, practices 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 datalinkms.com – Datalink MS Medical Billing Solutions » Insurance Eligibility Verification, services and maximum benefits met can alter eligibility.
2) Assuring accurate and finished patient information: Mistakes can be created in data entry when someone is wanting to be speedy in the interests of efficiency. Even slightest inaccuracy in patient information submitted for eligibility verification may cause a domino effect of issues. Triple checking the precision of the eligibility entries will look like it wastes time, however it helps you to save time in the end saving practice managers from unnecessary insurance company calls and follow-up. Make certain you hold the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to mention a few).
3) Choosing wisely when according to clearing houses: While clearing houses can provide fast access to eligibility information, they usually tend not to offer all information you need to accurately verify a patient’s eligibility. Generally, a telephone call made to a representative with an insurance company is essential to assemble all needed eligibility information.
4) Knowing exactly what an individual owes before they can arrive at the appointment: You should know and be ready to advise the patient on the exact amount they owe for any visit before they even arrive at the office. This will save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the assistance of credit bureaus to accumulate on balances owed.
5) Having a verification template specific towards the office’s/physician’s specialty. Defined and specific questions for coverage related to your specialty of practice will be a major help. Its not all specialties are the same, nor could they be treated the identical by insurance company requirements and coverage for claims and billing.
Since we said, it’s practically impossible for those practice operations to operate smoothly. There are inevitable pitfalls and areas vulnerable to issues. It is essential to begin a defined workflow plan that includes mixture of technology and outsourcing if necessary to accomplish consistency and accountability.
Insurance verification and insurance authorization is the method of validating the patient’s insurance details and obtaining assurance by calling the insurance coverage payer or through online verification. This process ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, kind of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and a lot more.
Datalinkms is a healthcare services company providing outsourcing and back office solutions for medical billing companies, medical offices, hospital billing departments, and hospital medical records departments. We offer Eligibility Verification to prevent insurance claim denials. Our service starts with retrieving a list of scheduled appointments and verifying insurance coverage for the patients. Once the verification is done the coverage data is put into the appointment scheduler for that office staff’s notification.