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 understandable the reasons 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 same can be said for physician eligibility verification. There are specialists you can outsource to, ultimately optimizing this process for that practice. For those who maintain the eligibility in-house, don’t overlook proven methods. Comply with these pointers to assist assure you have it right each and every time and reduce the chance of insurance claim issues and improve your revenue.
Top Five Overlooked Methods Proven to Boost 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. Very often, 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 Datalink MS Medical Billing Solutions & Insurance Eligibility Verification, 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 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 accuracy of the eligibility entries will appear to be it wastes time, nevertheless it helps you to save time in the end saving practice managers from unnecessary insurance carrier 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 depending on clearing houses: While clearing houses will offer fast access to eligibility information, they normally usually do not offer all important information to accurately verify a patient’s eligibility. More often than not, a phone call made to a representative with an insurance carrier is important to collect all needed eligibility information.
4) Knowing exactly what the patient owes before they even get through to the appointment: You should know and anticipate to advise a patient on the exact amount they owe for any visit before they even can get through to the office. This will save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as 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 regarding your specialty of practice will certainly be a major help. Not all specialties are the same, nor will they be treated exactly the same by insurance provider requirements and coverage for claims and billing.
Since we said, it’s practically impossible for many practice operations to operate smoothly. You will find inevitable pitfalls and areas susceptible to issues. It is essential to create a defined workflow plan that includes mixture of technology and outsourcing if required to achieve consistency and accountability.
Insurance verification and insurance authorization is the method 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 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. Our company offers Eligibility Verification for preventing insurance claim denials. Our service begins with retrieving a listing of scheduled appointments and verifying insurance policy coverage for your patients. Once the verification is carried out the policy data is put straight into the appointment scheduler for your office staff’s notification.