Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the difficulties related to 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.

The same can be said for physician eligibility verification. You will find specialists you can outsource to, ultimately optimizing the procedure for the practice. For those who keep up with the eligibility in-house, don’t overlook proven methods. Abide by these tips to help guarantee get it right every time and reduce the potential risk of insurance claim issues and optimize your revenue.

Top 5 Overlooked Methods Proven 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. Frequently, practices tend not to re-verify existing patient information because it’s assumed their qualifying information will stay the same. Not the case. 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 complete patient information: Mistakes can be made in data entry when someone is wanting to become speedy for the sake of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the precision of your eligibility entries will appear to be it wastes time, nevertheless it helps you to save time in the long run 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 for the insured correct (just for example).

3) Choosing wisely when based on clearing houses: While clearing houses will offer fast access to eligibility information, they usually tend not to offer all important information to accurately verify a patient’s eligibility. Most of the time, a phone call created to a representative at an insurance carrier is necessary to gather all needed eligibility information.

4) Knowing just what a patient owes before they even can get through to the appointment: You should know and be ready to advise the patient on the exact amount they owe for any visit before they can reach the office. This may save time and money for any practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the help of credit bureaus to collect on balances owed.

5) Using a verification template specific for the office’s/physician’s specialty. Defined and particular questions for coverage pertaining to 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. There are inevitable pitfalls and areas vulnerable to issues. It is important to establish a defined workflow plan that includes mix of technology and outsourcing if needed to accomplish consistency and accountability.

Insurance verification and insurance authorization is the procedure of validating the patient’s insurance details and obtaining assurance by calling the insurance coverage payer or through online verification. The procedure ensures verification of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, kind of xcorrq and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time 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 for preventing insurance claim denials. Our service starts off with retrieving a listing of scheduled appointments and verifying insurance coverage for that patients. After the verification is performed the policy facts are put straight into the appointment scheduler for your office staff’s notification.

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