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 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.
The same can probably be said for physician eligibility verification. There are specialists you can outsource to, ultimately optimizing the process for your practice. For individuals who keep up with the eligibility in-house, don’t overlook proven methods. Abide by these pointers to help guarantee have it right each and every time and lower the potential risk of insurance claim issues and optimize your revenue.
Top Five Overlooked Methods Seen to Boost 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. Quite often, practices tend not to 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 finish patient information: Mistakes can be created in data entry when someone is trying to be speedy in the interest of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the precision of the eligibility entries will seem like it wastes time, but it can save time over time 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 for the insured correct (just to name a few).
3) Choosing wisely when based on clearing houses: While clearing houses can offer fast access to eligibility information, they usually tend not to offer all information you need to accurately verify a patient’s eligibility. Most of the time, a call made to a representative at an insurance company is essential to collect all needed eligibility information.
4) Knowing exactly what an individual owes before they can reach the appointment: You need to know and anticipate 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 as well as enlisting the help of credit bureaus to collect on balances owed.
5) Using a verification template specific for the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will be a major help. Not all specialties are similar, nor are they treated the same by insurance carrier requirements and coverage for claims and billing.
As we said, it’s practically impossible for all practice operations to run smoothly. You will find inevitable pitfalls and areas susceptible to issues. It is important to establish a defined workflow plan which 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 coverage 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 much 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. We offer Eligibility Verification to prevent insurance claim denials. Our service begins with retrieving a list of scheduled appointments and verifying insurance coverage for your patients. Once the verification is done the coverage facts are put straight into the appointment scheduler for that office staff’s notification.