Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the difficulties 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 same can be stated for physician eligibility verification. There are specialists you are able to outsource to, ultimately optimizing the process for your practice. For people who keep up with the eligibility in-house, don’t overlook proven methods. Comply with these pointers to aid guarantee you get it right each time and minimize the potential risk of insurance claim issues and maximize your revenue.
Top 5 Overlooked Methods Seen to Boost 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. Frequently, practices usually do not re-verify existing patient information because it’s assumed their qualifying information will stay the same. Not the case. 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 complete patient information: Mistakes can be made in data entry when someone is wanting to be speedy in the interest 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 the eligibility entries will look like it wastes time, however it will save time over time saving practice managers from unnecessary insurance company 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 according to clearing houses: While clearing houses can provide fast 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 made to an agent at an insurance company is important to collect all needed eligibility information.
4) Knowing precisely what the patient owes before they even can get through to the appointment: You have to know and be ready to advise the patient on the exact amount they owe for a 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 as well as enlisting the assistance of credit bureaus to gather on balances owed.
5) Using a verification template specific towards the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will certainly be a major help. Not every specialties are similar, nor will they be treated the same by insurance provider requirements and coverage for claims and billing.
Since we said, it’s practically impossible for many practice operations to perform smoothly. You will find inevitable pitfalls and areas prone to issues. It is important to create a defined workflow plan which includes mix of technology and outsourcing if needed to attain consistency and accountability.
Insurance verification and insurance authorization is the process 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, life time maximum and a lot 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 to prevent insurance claim denials. Our service begins with retrieving a summary of scheduled appointments and verifying insurance policy coverage for the patients. Once the verification is done the policy details are put straight into the appointment scheduler for the office staff’s notification.