Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the problems connected with eligibility reporting, and it’s understandable why many practices battle with staying current and optimizing the various tools offered to them. I correlate it to taxes – tax accountants are paid to stay current with everything and therefore increase the return to each customer.
The same can be stated for electronic eligibility verification. You can find specialists you are able to outsource to, ultimately optimizing the procedure for your practice. For individuals who maintain the eligibility in-house, don’t overlook proven methods. Abide by these guidelines to help guarantee obtain it right each time and reduce the potential risk of insurance claim issues and optimize your revenue.
Top Five 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. Very often, practices do not re-verify existing patient information because it’s assumed their qualifying information will remain the same. Untrue. Change of employment, change of insurance policy coverage or company, 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 trying to get speedy for the sake of efficiency. Even slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the precision of your eligibility entries will appear to be it wastes time, however it helps you to save time over time 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 for the insured correct (just for example).
3) Choosing wisely when depending on clearing houses: While clearing houses can provide fast access to eligibility information, they normally do not offer all important information to accurately verify a patient’s eligibility. More often than not, a call created to a representative in an insurance company is necessary to assemble all needed eligibility information.
4) Knowing just what a patient owes before they can arrive at the appointment: You have to know and anticipate to advise the patient on the exact amount they owe for a visit before they can arrive at the office. This can save money and time for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the assistance of cgigcm bureaus to collect on balances owed.
5) Having a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice is a major help. Not every specialties are identical, nor are they treated the identical by insurance provider requirements and coverage for claims and billing.
As we said, it’s practically impossible for many practice operations to perform smoothly. You will find inevitable pitfalls and areas vulnerable to issues. It is essential to create a defined workflow plan that includes mixture of technology and outsourcing if required to attain 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. Our company offers Eligibility Verification for preventing insurance claim denials. Our service starts off with retrieving a list of scheduled appointments and verifying insurance policy for the patients. Once the verification is performed the coverage details are put into the appointment scheduler for the office staff’s notification.