Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the issues related to eligibility reporting, and it is easy to understand why many practices struggle with staying current and optimizing the tools offered to them. I link it to taxes – tax accountants are paid to stay current with everything and thus maximize the return to each customer.
Exactly the same can probably be said for medical eligibility check. There are specialists it is possible to outsource to, ultimately optimizing the process for the practice. For individuals who retain the eligibility in-house, don’t overlook proven methods. Adhere to these tips to assist guarantee you obtain it right each time and minimize the potential risk of insurance claim issues and improve your revenue.
Top 5 Overlooked Methods Seen 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. Frequently, practices tend not to 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 finish patient information: Mistakes can be produced in data entry when someone is trying to be speedy in the interests 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 seem like it wastes time, however it can save time in the end saving practice managers from unnecessary insurance carrier calls and follow-up. Make certain you possess the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to name a few).
3) Choosing wisely when according to clearing houses: While clearing houses will offer 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 created to an agent at an insurance company is necessary to assemble all needed eligibility information.
4) Knowing just what an individual owes before they can get through to the appointment: You should know and anticipate to advise an individual on the exact amount they owe for any visit before they even get through to the office. This will save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the aid of cgigcm bureaus to collect on balances owed.
5) Possessing a verification template specific towards the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will certainly be a major help. Its not all specialties are similar, nor could they be treated the same by insurance company requirements and coverage for claims and billing.
While we said, it’s practically impossible for all practice operations to operate smoothly. You will find inevitable pitfalls and areas susceptible to issues. It is important to establish a defined workflow plan which includes combination of technology and outsourcing if required 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 offer Eligibility Verification for preventing insurance claim denials. Our service begins with retrieving a summary of scheduled appointments and verifying insurance coverage for that patients. Once the verification is done the coverage facts are put directly into the appointment scheduler for your office staff’s notification.