Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the issues associated with 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 said for physician eligibility verification. There are specialists it is possible to outsource to, ultimately optimizing this process for the practice. For those who retain the eligibility in-house, don’t overlook proven methods. Abide by these tips to help guarantee get it right each time and reduce the chance of insurance claim issues and maximize 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 needs to have their eligibility verified Every. Single. Visit. Quite often, practices do not 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 finished patient information: Mistakes can be created in data entry when someone is wanting to be 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 your eligibility entries will seem like it wastes time, but it will save time in the long run saving practice managers from unnecessary insurance provider calls and follow-up. Make certain you have the patient’s name spelling, birth date, policy number and relationship to the insured correct (just to mention a few).
3) Choosing wisely when according to clearing houses: While clearing houses can offer quick access to eligibility information, they most times usually do not offer all necessary information to accurately verify a patient’s eligibility. Most of the time, a telephone call made to an agent with an insurance company is essential to assemble all needed eligibility information.
4) Knowing exactly what a patient owes before they can arrive at the appointment: You should know and be ready to advise a patient on the exact amount they owe for a visit before they even can reach the office. This will save money and time to get a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the aid of credit bureaus to collect on balances owed.
5) Having a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage related to your specialty of practice will certainly be a major help. Its not all specialties are identical, nor are they treated the identical by insurance company requirements and coverage for claims and billing.
Since we said, it’s practically impossible for many practice operations to operate smoothly. You will find inevitable pitfalls and areas vulnerable to issues. It is essential to create a defined workflow plan that includes combination of technology and outsourcing if necessary to accomplish consistency and accountability.
Insurance verification and insurance authorization is the procedure of validating the patient’s insurance details and obtaining assurance by calling the insurance policy 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, life time maximum and much 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. Our company offers Eligibility Verification for preventing insurance claim denials. Our service begins with retrieving a list of scheduled appointments and verifying insurance policy for that patients. When the verification is performed the policy data is put directly into the appointment scheduler for the office staff’s notification.