Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the problems connected with eligibility reporting, and it’s easy to understand why many practices have a problem with staying current and optimizing the equipment available to them. I link it to taxes – tax accountants are paid to stay current with everything and thus maximize the return to each customer.
The identical can be stated for check medical eligibility. There are specialists you are able to outsource to, ultimately optimizing the procedure for that practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Adhere to these tips to help guarantee obtain it right each and every time and minimize the chance 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 each and every 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 stay the same. Untrue. Change of employment, change of insurance coverage or company, 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 get speedy for the sake 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 towards the insured correct (just to name a few).
3) Choosing wisely when based on clearing houses: While clearing houses can provide fast access to eligibility information, they most times tend not to offer all information you need to accurately verify a patient’s eligibility. More often than not, a phone call made to a representative at an insurance provider is essential to assemble all needed eligibility information.
4) Knowing just what an individual owes before they can get through to the appointment: You need to know and anticipate to advise an individual on the exact amount they owe for any visit before they even can arrive at the office. This may save time and money for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the assistance of cgigcm bureaus to collect on balances owed.
5) Using a verification template specific to 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 could they be treated the identical by insurance provider requirements and coverage for claims and billing.
Since we said, it’s practically impossible for those practice operations to run smoothly. There are inevitable pitfalls and areas susceptible to issues. It is important to begin a defined workflow plan which includes combination of technology and outsourcing if needed to accomplish consistency and accountability.
We have been 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 for preventing insurance claim denials. Our service starts off with retrieving a summary of scheduled appointments and verifying insurance coverage for that patients. When the verification is done the coverage data is put into the appointment scheduler for your office staff’s notification.