Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the issues connected 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 probably be said for physician eligibility verification. You can find specialists you can outsource to, ultimately optimizing the procedure for that practice. For those who maintain the eligibility in-house, don’t overlook proven methods. Comply with these guidelines to help guarantee you get it right every time and reduce the risk of insurance claim issues and optimize your revenue.
Top Five Overlooked Methods Proven 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 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 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 created in data entry when someone is attempting to get speedy in the interests 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 helps you to save time over time saving practice managers from unnecessary insurance company calls and follow-up. Be sure that you possess the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to mention a few).
3) Choosing wisely when based on clearing houses: While clearing houses can provide quick access to eligibility information, they most times do not offer all information you need to accurately verify a patient’s eligibility. More often than not, a phone call designed to a representative with an insurance provider is important to assemble all needed eligibility information.
4) Knowing exactly what a patient owes before they can arrive at the appointment: You need to know and be ready to advise an individual on the exact amount they owe to get a visit before they even can get through to the office. This can save time and money to get 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) Having a verification template specific for the office’s/physician’s specialty. Defined and particular questions for coverage regarding your specialty of practice will be a major help. Its not all specialties are the same, nor are they treated exactly the same by insurance carrier requirements and coverage for claims and billing.
While we said, it’s practically impossible for all practice operations to run smoothly. There are inevitable pitfalls and areas prone to issues. It is essential to create a defined workflow plan that also includes mixture of technology and outsourcing if necessary to accomplish 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. This process ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, form of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum and a lot 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 for preventing insurance claim denials. Our service begins with retrieving a summary of scheduled appointments and verifying insurance policy coverage for that patients. After the verification is carried out the policy details are put directly into the appointment scheduler for your office staff’s notification.