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 is understandable why many practices have a problem 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 therefore maximize the return to each customer.
The same can be said for medi-cal eligibility verification system. You will find specialists you can outsource to, ultimately optimizing the process for your practice. For individuals who keep up with the eligibility in-house, don’t overlook proven methods. Comply with these guidelines to aid guarantee have it right every time and lower 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 and every visit: New and existing patients needs to have their eligibility verified Every. Single. Visit. Frequently, practices do not 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 created in data entry when someone is trying to get speedy for the sake of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification can cause a domino effect of issues. Triple checking the accuracy of the eligibility entries will look like it wastes time, but it can save time in the end saving practice managers from unnecessary insurance carrier calls and follow-up. Make certain you possess the patient’s name spelling, birth date, policy number and relationship to the insured correct (just for example).
3) Choosing wisely when based on clearing houses: While clearing houses can provide quick access to eligibility information, they most times do not offer all information you need to accurately verify a patient’s eligibility. Generally, a telephone call made to a representative at an insurance company is necessary to assemble all needed eligibility information.
4) Knowing exactly what an individual owes before they even can reach the appointment: You need to know and anticipate to advise the patient on the exact amount they owe for a visit before they even can arrive at the office. This may save money and time to get a practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the assistance of cgigcm bureaus to accumulate on balances owed.
5) Using a verification template specific to the office’s/physician’s specialty. Defined and specific questions for coverage regarding your specialty of practice will certainly be a major help. Not every specialties are the same, nor will they be treated exactly the same by insurance company requirements and coverage for claims and billing.
As we said, it’s practically impossible for many practice operations to operate smoothly. You will find inevitable pitfalls and areas prone to issues. You should begin a defined workflow plan that also includes mix of technology and outsourcing if required to accomplish consistency and accountability.
We are 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 with retrieving a list of scheduled appointments and verifying insurance policy coverage for that patients. After the verification is carried out the coverage details are put directly into the appointment scheduler for that office staff’s notification.