Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the issues connected with eligibility reporting, and it’s understandable why many practices have a problem 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 so increase the return to each customer.
The identical can probably be said for verify insurance eligibility. There are specialists you are able to outsource to, ultimately optimizing this process for that practice. For those who keep up with the eligibility in-house, don’t overlook proven methods. Abide by these tips to aid guarantee you have it right each time and lower the chance of insurance claim issues and maximize your revenue.
Top 5 Overlooked Methods Shown to Increase the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility every single visit: New and existing patients must have their eligibility verified Every. Single. Visit. Very often, practices usually do not re-verify existing patient information because it’s assumed their qualifying information will stay the same. Incorrect. Change of employment, change of insurance coverage or company, services and maximum benefits met can alter eligibility.
2) Assuring accurate and complete patient information: Mistakes can be made in data entry when someone is wanting to get speedy for the sake 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 own eligibility entries will look like it wastes time, nevertheless it will save time in the long run saving practice managers from unnecessary insurance company calls and follow-up. Ensure that you possess the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just to mention a few).
3) Choosing wisely when according to clearing houses: While clearing houses can offer quick access to eligibility information, they most times tend not to offer all information you need to accurately verify a patient’s eligibility. Generally, a call designed to a representative with an insurance provider is essential to assemble all needed eligibility information.
4) Knowing precisely what an individual owes before they can reach the appointment: You should know and anticipate to advise a patient on the exact amount they owe for a visit before they can get through to the office. This will save time and money to get a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the aid of cgigcm bureaus to gather on balances owed.
5) Using a verification template specific to the office’s/physician’s specialty. Defined and particular questions for coverage pertaining to your specialty of practice will be a major help. Not every specialties are similar, nor will they be treated the identical by insurance company requirements and coverage for claims and billing.
As we said, it’s practically impossible for many practice operations to operate smoothly. You will find inevitable pitfalls and areas prone to issues. It is important to begin a defined workflow plan that includes combination of technology and outsourcing if needed to attain consistency and accountability.
We are 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 begins with retrieving a listing of scheduled appointments and verifying insurance policy coverage for your patients. After the verification is performed the policy details are put directly into the appointment scheduler for that office staff’s notification.