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 battle with staying current and optimizing the equipment accessible to them. I link 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 said for medicare eligibility verification for providers. You will find specialists it is possible to outsource to, ultimately optimizing the procedure for that practice. For those who maintain the eligibility in-house, don’t overlook proven methods. Abide by these pointers to assist assure you have it right each time and lower the chance of insurance claim issues and improve your revenue.
Top Five Overlooked Methods Seen to Raise 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 remain the same. Untrue. Change of employment, change of insurance policy or company, 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 attempting to get speedy in the interest of efficiency. Including the slightest inaccuracy in patient information submitted for eligibility verification can cause a domino effect of issues. Triple checking the accuracy of your eligibility entries will seem like it wastes time, but it helps you to save time over time saving practice managers from unnecessary insurance carrier 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 based on clearing houses: While clearing houses can offer 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 an agent at an insurance carrier is necessary to assemble all needed eligibility information.
4) Knowing exactly what the patient owes before they even can reach the appointment: You need to know and anticipate to advise the patient on the exact amount they owe to get a visit before they can arrive at the office. This will save money and time for 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) Possessing a verification template specific to the office’s/physician’s specialty. Defined and particular questions for coverage related to your specialty of practice will be a major help. Not every specialties are similar, nor could they be treated exactly the same by insurance company requirements and coverage for claims and billing.
While we said, it’s practically impossible for many practice operations to perform smoothly. You will find inevitable pitfalls and areas prone to issues. You should create a defined workflow plan that also includes mixture of technology and outsourcing if needed to accomplish 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 begins with retrieving a list of scheduled appointments and verifying insurance policy coverage for the patients. After the verification is performed the coverage data is put directly into the appointment scheduler for that office staff’s notification.