Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the problems 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.
Exactly the same can be stated for physician eligibility verification. There are specialists it is possible to outsource to, ultimately optimizing the procedure for your practice. For individuals who maintain the eligibility in-house, don’t overlook proven methods. Abide by these guidelines to aid assure you obtain it right each time and minimize the risk of insurance claim issues and maximize your revenue.
Top Five 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 should 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. Not the case. Change of employment, change of datalinkms.com – Datalink MS Medical Billing Solutions » Insurance Eligibility Verification, services and maximum benefits met can alter eligibility.
2) Assuring accurate and finish patient information: Mistakes can be made in data entry when someone is wanting to become speedy in the interests of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the accuracy of your eligibility entries will seem like it wastes time, however it can save time over time saving practice managers from unnecessary insurance carrier calls and follow-up. Be sure that you possess 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 quick access to eligibility information, they most times usually do not offer all necessary information to accurately verify a patient’s eligibility. Generally, a telephone call made to a representative at an insurance carrier is important to assemble all needed eligibility information.
4) Knowing exactly what an individual owes before they even get through to the appointment: You need to know and be ready to advise the patient on the exact amount they owe to get a visit before they even arrive at the office. This can save time and money for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the help of credit bureaus to accumulate on balances owed.
5) Using a verification template specific to the office’s/physician’s specialty. Defined and particular questions for coverage regarding your specialty of practice will be a major help. Its not all specialties are identical, nor could they be treated exactly the same by insurance carrier requirements and coverage for claims and billing.
Since we said, it’s practically impossible for those practice operations to perform smoothly. You can find inevitable pitfalls and areas vulnerable to issues. You should establish a defined workflow plan which includes combination of technology and outsourcing if necessary to accomplish 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. This process ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, form of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, lifetime maximum and a lot 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 starts off with retrieving a summary of scheduled appointments and verifying insurance policy for the patients. Once the verification is performed the policy facts are put directly into the appointment scheduler for that office staff’s notification.