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 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.
Exactly the same can probably be said for physician eligibility verification. You can find specialists you can outsource to, ultimately optimizing the process for that practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Abide by these tips to help assure you obtain it right each and every time and reduce the 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 every single visit: New and existing patients needs to have their eligibility verified Every. Single. Visit. Frequently, 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 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 created in data entry when someone is attempting to become 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 precision of the eligibility entries will appear to be it wastes time, however it will save time in the end saving practice managers from unnecessary insurance provider calls and follow-up. Be sure that you have the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to name a few).
3) Choosing wisely when according to clearing houses: While clearing houses can 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 created to an agent at an insurance company is necessary to collect all needed eligibility information.
4) Knowing just what the patient owes before they even get through to the appointment: You have to know and be ready to advise a patient on the exact amount they owe for any visit before they can get through to the office. This may save time and money for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the assistance of credit bureaus to accumulate on balances owed.
5) Having a verification template specific for 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 identical, nor could they be treated the identical by insurance carrier requirements and coverage for claims and billing.
As we said, it’s practically impossible for all practice operations to perform smoothly. There are inevitable pitfalls and areas vulnerable to issues. You should begin a defined workflow plan which includes combination of technology and outsourcing if necessary 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, form of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time 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 for preventing insurance claim denials. Our service starts with retrieving a list of scheduled appointments and verifying insurance coverage for your patients. When the verification is done the coverage data is put directly into the appointment scheduler for that office staff’s notification.