Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the difficulties 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.
The identical can be said for physician eligibility verification. You will find specialists you can outsource to, ultimately optimizing the process for your practice. For people who keep up with the eligibility in-house, don’t overlook proven methods. Adhere to these tips to assist assure you have it right every time and reduce the potential risk of insurance claim issues and improve your revenue.
Top 5 Overlooked Methods Shown to Boost 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. Not the case. Change of employment, change of www.datalinkms.com 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 made in data entry when someone is trying to be speedy in the interest of efficiency. Including the slightest inaccuracy in patient information submitted for eligibility verification can cause a domino effect of issues. Triple checking the precision of your eligibility entries will appear to be it wastes time, however it will save time in the end saving practice managers from unnecessary insurance company calls and follow-up. Make certain you have the patient’s name spelling, birth date, policy number and relationship to the insured correct (just for example).
3) Choosing wisely when based on clearing houses: While clearing houses can offer quick access to eligibility information, they most times do not offer all necessary information to accurately verify a patient’s eligibility. Generally, a call made to a representative in an insurance carrier is essential to assemble all needed eligibility information.
4) Knowing exactly what the patient owes before they can reach the appointment: You have to know and be ready to advise an individual on the exact amount they owe to get a visit before they even can arrive at the office. This will save money and time for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the aid of credit bureaus to gather 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 is a major help. Its not all specialties are the same, 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 many practice operations to run smoothly. You will find inevitable pitfalls and areas prone to issues. It is important to establish a defined workflow plan that includes mixture of technology and outsourcing if needed 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 policy payer or through online verification. The procedure 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 a lot 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 starts with retrieving a list of scheduled appointments and verifying insurance policy for your patients. Once the verification is done the policy data is put into the appointment scheduler for that office staff’s notification.