Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the difficulties related to 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.
The same can be said for physician eligibility verification. You can find specialists you are able to outsource to, ultimately optimizing the procedure for your practice. For people who retain the eligibility in-house, don’t overlook proven methods. Abide by these tips to aid guarantee have it right every time and minimize the chance of insurance claim issues and improve your revenue.
Top 5 Overlooked Methods Proven 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. Quite often, practices do not re-verify existing patient information because it’s assumed their qualifying information will remain the same. Untrue. 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 finished patient information: Mistakes can be created in data entry when someone is attempting to become speedy in the interest of efficiency. Even slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the accuracy of your own eligibility entries will seem like it wastes time, however it can save time in the long run saving practice managers from unnecessary insurance carrier calls and follow-up. Be sure that you have the patient’s name spelling, birth date, policy number and relationship towards the insured correct (just for example).
3) Choosing wisely when depending on clearing houses: While clearing houses can offer fast access to eligibility information, they usually do not offer all important information to accurately verify a patient’s eligibility. Most of the time, a telephone call made to an agent with an insurance provider is essential to assemble all needed eligibility information.
4) Knowing precisely what a patient owes before they even get through to the appointment: You need to know and anticipate to advise a patient on the exact amount they owe for any visit before they even get through to the office. This can save money and time for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the aid of credit bureaus to accumulate 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 be a major help. Not all specialties are identical, nor will they be treated the same by insurance carrier requirements and coverage for claims and billing.
While we said, it’s practically impossible for all practice operations to operate smoothly. There are inevitable pitfalls and areas susceptible to issues. You should establish a defined workflow plan that includes mixture of technology and outsourcing if necessary to achieve 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 coverage 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, type of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and much more.
Datalinkms is actually a healthcare services company providing outsourcing and back-office solutions for medical billing companies, medical offices, hospital billing departments, and hospital medical records departments. Our company offers Eligibility Verification to prevent insurance claim denials. Our service begins with retrieving a listing of scheduled appointments and verifying insurance policy for the patients. When the verification is carried out the policy details are put directly into the appointment scheduler for that office staff’s notification.