Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the difficulties associated with eligibility reporting, and it’s easy to understand why many practices battle with staying current and optimizing the tools offered to them. I link it to taxes – tax accountants are paid to stay current with everything and thus increase the return to each customer.

The identical can be said for medical eligibility. There are specialists you are able to outsource to, ultimately optimizing the process for your practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Comply with these guidelines to assist assure you obtain it right each time and reduce the risk of insurance claim issues and maximize your revenue.

Top Five Overlooked Methods Seen to Boost the Efficiency, Accuracy of Eligibility Verification.

1) Verifying existing and new patient eligibility each visit: New and existing patients must have their eligibility verified Every. Single. Visit. Frequently, practices tend not to re-verify existing patient information because it’s assumed their qualifying information will remain the same. Not the case. Change of employment, change of insurance policy coverage or company, services and maximum benefits met can alter eligibility.

2) Assuring accurate and finished patient information: Mistakes can be produced in data entry when someone is trying to become speedy in the interest 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 the eligibility entries will seem like it wastes time, nevertheless it helps you to save time in the long run saving practice managers from unnecessary insurance company calls and follow-up. Be sure that you possess 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 normally do not offer all necessary information to accurately verify a patient’s eligibility. Most of the time, a telephone call created to an agent with an insurance carrier is important to assemble all needed eligibility information.

4) Knowing precisely what the patient owes before they even arrive at the appointment: You should know and anticipate to advise a patient on the exact amount they owe for any visit before they even arrive at the office. This will save money and time 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 every specialties are identical, nor will they be treated the same 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 important to create a defined workflow plan which includes mixture of technology and outsourcing if necessary 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 offer Eligibility Verification to prevent insurance claim denials. Our service starts with retrieving a list of scheduled appointments and verifying insurance coverage for that patients. Once the verification is carried out the policy details are put into the appointment scheduler for the office staff’s notification.