Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the difficulties associated with eligibility reporting, and it is easy to understand why many practices battle with staying current and optimizing the various tools available to them. I correlate it to taxes – tax accountants are paid to stay current with everything and so increase the return to each customer.
The identical can be said for insurance eligibility verification. You will find specialists you can outsource to, ultimately optimizing the procedure for the practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Comply with these tips to aid guarantee have it right each and every time and lower the potential risk of insurance claim issues and maximize 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 should 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. Untrue. Change of employment, change of insurance coverage or company, 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 wanting to be 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 the eligibility entries will seem like it wastes time, however it helps you to save time in the end saving practice managers from unnecessary insurance provider calls and follow-up. Make certain you hold the patient’s name spelling, birth date, policy number and relationship to the insured correct (just to name a few).
3) Choosing wisely when depending on clearing houses: While clearing houses can provide quick access to eligibility information, they most times tend not to offer all necessary information to accurately verify a patient’s eligibility. More often than not, a call made to an agent in an insurance carrier is important to gather all needed eligibility information.
4) Knowing precisely what an individual owes before they even can arrive at the appointment: You need to know and be ready to advise the patient on the exact amount they owe for a visit before they can arrive at the office. This can save time and money to get a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the aid of cgigcm bureaus to accumulate on balances owed.
5) Having a verification template specific towards the office’s/physician’s specialty. Defined and particular questions for coverage regarding your specialty of practice will certainly be a major help. Not every specialties are identical, nor could they be treated the identical by insurance carrier requirements and coverage for claims and billing.
While we said, it’s practically impossible for many practice operations to perform smoothly. There are inevitable pitfalls and areas vulnerable to issues. It is important to begin a defined workflow plan that includes mixture of technology and outsourcing if required to accomplish consistency and accountability.
We are 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 begins with retrieving a summary of scheduled appointments and verifying insurance coverage for the patients. When the verification is done the coverage data is put into the appointment scheduler for that office staff’s notification.