Changing policies. New forms. Added steps to the process. Pick these, yet alone the longer laundry list of the problems related to eligibility reporting, and it’s easy to understand why many practices struggle with staying current and optimizing the equipment offered to them. I link it to taxes – tax accountants are paid to stay current with everything and so increase the return to each customer.
The same can probably be said for insurance verification companies. You will find specialists you can outsource to, ultimately optimizing the procedure for the practice. For individuals who maintain the eligibility in-house, don’t overlook proven methods. Adhere to these pointers to aid assure you get it right each time and reduce the risk 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 each visit: New and existing patients needs to have their eligibility verified Every. Single. Visit. Very often, practices tend not to re-verify existing patient information because it’s assumed their qualifying information will stay the same. Incorrect. Change of employment, change of insurance policy coverage or company, services and maximum benefits met can alter eligibility.
2) Assuring accurate and finish patient information: Mistakes can be produced in data entry when someone is wanting to be speedy in the interest of efficiency. Even slightest inaccuracy in patient information submitted for eligibility verification may cause a domino effect of issues. Triple checking the precision of your eligibility entries will appear to be it wastes time, but it will save time in the end saving practice managers from unnecessary insurance company calls and follow-up. Be sure that you have the patient’s name spelling, birth date, policy number and relationship to the insured correct (just to mention a few).
3) Choosing wisely when depending on clearing houses: While clearing houses can provide fast access to eligibility information, they most times tend not to offer all important information to accurately verify a patient’s eligibility. More often than not, a telephone call designed to a representative at an insurance provider is necessary to assemble all needed eligibility information.
4) Knowing exactly what a patient owes before they can reach the appointment: You have to know and be ready to advise a patient on the exact amount they owe to get a visit before they can reach the office. This will save time and money for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and even enlisting the assistance of cgigcm bureaus to accumulate on balances owed.
5) Possessing a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage regarding your specialty of practice will be a major help. Not all specialties are the same, nor could they be treated the identical by insurance carrier requirements and coverage for claims and billing.
Since we said, it’s practically impossible for all practice operations to operate smoothly. You can find inevitable pitfalls and areas prone to issues. It is essential to begin a defined workflow plan that also includes mix of technology and outsourcing if required to achieve 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. We provide Eligibility Verification to prevent insurance claim denials. Our service starts with retrieving a summary of scheduled appointments and verifying insurance policy for your patients. After the verification is done the coverage data is put directly into the appointment scheduler for your office staff’s notification.