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 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.
Exactly the same can probably be said for physician eligibility verification. You can find specialists you are able to outsource to, ultimately optimizing this process for that practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Adhere to these guidelines to help assure you obtain it right every time and reduce the potential risk of insurance claim issues and optimize your revenue.
Top 5 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 must have their eligibility verified Every. Single. Visit. Frequently, practices 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 finished patient information: Mistakes can be made in data entry when someone is attempting to get speedy in the interests of efficiency. Including the 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 will save time in the end saving practice managers from unnecessary insurance company calls and follow-up. Make certain you have the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to mention a few).
3) Choosing wisely when depending on clearing houses: While clearing houses can offer quick access to eligibility information, they normally usually do not offer all information you need to accurately verify a patient’s eligibility. Generally, a telephone call created to a representative with an insurance company is important to assemble all needed eligibility information.
4) Knowing exactly what a patient owes before they can arrive at the appointment: You should know and anticipate to advise the patient on the exact amount they owe for any visit before they even reach 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 assistance of credit bureaus to collect on balances owed.
5) Possessing a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage related to your specialty of practice will be a major help. Its not all specialties are similar, nor could they be treated exactly the same by insurance company requirements and coverage for claims and billing.
While we said, it’s practically impossible for many practice operations to operate smoothly. You will find inevitable pitfalls and areas prone to issues. You should begin a defined workflow plan that also includes combination of technology and outsourcing if necessary to accomplish consistency and accountability.
Insurance verification and insurance authorization is the procedure of validating the patient’s insurance details and obtaining assurance by calling the insurance 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, kind of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and much more.
Datalinkms is 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 listing of scheduled appointments and verifying insurance policy for that patients. When the verification is performed the coverage details are put directly into the appointment scheduler for your office staff’s notification.