Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the problems associated with eligibility reporting, and it’s understandable why many practices battle with staying current and optimizing the equipment offered to them. I link it to taxes – tax accountants are paid to stay current with everything and thus maximize the return to each customer.
The same can probably be said for medi cal eligibility check. There are specialists you are able to outsource to, ultimately optimizing the process for that practice. For people who retain the eligibility in-house, don’t overlook proven methods. Abide by these pointers to aid guarantee get it right each time and lower the potential risk of insurance claim issues and optimize your revenue.
Top 5 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 complete patient information: Mistakes can be created in data entry when someone is attempting to be speedy for the sake of efficiency. Even slightest inaccuracy in patient information submitted for eligibility verification may cause a domino effect of issues. Triple checking the precision of your own eligibility entries will appear to be it wastes time, nevertheless it helps you to save time in the end saving practice managers from unnecessary insurance provider 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 mention a few).
3) Choosing wisely when according to clearing houses: While clearing houses can offer quick access to eligibility information, they normally tend not to offer all necessary information to accurately verify a patient’s eligibility. More often than not, a call created to an agent in an insurance company is important to collect all needed eligibility information.
4) Knowing exactly what an individual owes before they can arrive at the appointment: You should know and be ready to advise the patient on the exact amount they owe for a visit before they can reach the office. This may save time and money for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the assistance of cgigcm bureaus to accumulate on balances owed.
5) Using a verification template specific for the office’s/physician’s specialty. Defined and particular questions for coverage related to your specialty of practice will certainly be a major help. Its not all specialties are identical, nor could they be treated the same by insurance carrier requirements and coverage for claims and billing.
As we said, it’s practically impossible for those practice operations to perform smoothly. There are inevitable pitfalls and areas vulnerable to issues. It is important to begin a defined workflow plan that includes mix of technology and outsourcing if needed to accomplish consistency and accountability.
Our company is 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 off with retrieving a list of scheduled appointments and verifying insurance policy for that patients. Once the verification is performed the coverage data is put straight into the appointment scheduler for your office staff’s notification.