Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the problems 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 will find specialists it is possible to outsource to, ultimately optimizing this process for the practice. For those who retain the eligibility in-house, don’t overlook proven methods. Adhere to these guidelines to aid guarantee you have it right every time and minimize the chance of insurance claim issues and maximize 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 needs to 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. Incorrect. Change of employment, change of www.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 be speedy for the sake of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification can cause a domino effect of issues. Triple checking the precision of your own eligibility entries will seem like it wastes time, nevertheless it will save time in the long run saving practice managers from unnecessary insurance provider calls and follow-up. Ensure that you have the patient’s name spelling, birth date, policy number and relationship for 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 do not offer all important information to accurately verify a patient’s eligibility. Most of the time, a call designed to a representative with an insurance provider is important to assemble all needed eligibility information.
4) Knowing precisely what a patient owes before they even reach the appointment: You need to know and be ready to advise a patient on the exact amount they owe for a visit before they even 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 credit bureaus to gather on balances owed.
5) Having a verification template specific for the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will be a major help. Not all specialties are the same, nor are they treated the same by insurance carrier requirements and coverage for claims and billing.
As we said, it’s practically impossible for those practice operations to run smoothly. There are inevitable pitfalls and areas susceptible to issues. You should create a defined workflow plan that includes mix of technology and outsourcing if necessary to attain 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 payer or through online verification. The process ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, kind of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and a lot more.
Datalinkms is really 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 to prevent insurance claim denials. Our service starts off with retrieving a list of scheduled appointments and verifying insurance coverage for the patients. When the verification is done the coverage facts are put straight into the appointment scheduler for the office staff’s notification.