Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the issues 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 said for physician eligibility verification. There are specialists you can outsource to, ultimately optimizing this process for that practice. For those who keep up with the eligibility in-house, don’t overlook proven methods. Abide by these tips to aid assure you get it right every time and lower the risk of insurance claim issues and maximize your revenue.
Top 5 Overlooked Methods Proven to Increase the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility each visit: New and existing patients should have their eligibility verified Every. Single. Visit. Very often, practices usually do not re-verify existing patient information because it’s assumed their qualifying information will remain the same. Incorrect. 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 made in data entry when someone is trying to become speedy in the interest of efficiency. Including the slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the precision of your eligibility entries will look like it wastes time, however 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 for the insured correct (just for example).
3) Choosing wisely when based on clearing houses: While clearing houses will offer fast access to eligibility information, they usually usually do not offer all important information to accurately verify a patient’s eligibility. Most of the time, a phone call made to an agent with an insurance company is essential to assemble all needed eligibility information.
4) Knowing exactly what the patient owes before they even get through to the appointment: You need to know and anticipate to advise a patient on the exact amount they owe for any visit before they even can get through to the office. This may save time and money for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the assistance of credit bureaus to collect on balances owed.
5) Having a verification template specific towards the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will be a major help. Not every specialties are the same, nor will they be treated the identical by insurance company requirements and coverage for claims and billing.
While we said, it’s practically impossible for those practice operations to operate smoothly. You can find inevitable pitfalls and areas vulnerable to issues. You should begin a defined workflow plan that also includes mixture of technology and outsourcing if required to attain 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 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, kind of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and more.
Datalinkms is actually 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 provide Eligibility Verification to prevent insurance claim denials. Our service starts off with retrieving a listing of scheduled appointments and verifying insurance coverage for that patients. When the verification is performed the policy facts are put straight into the appointment scheduler for the office staff’s notification.