Changing policies. New forms. Added steps to the process. Pick any one of these, yet alone the longer laundry list of the problems connected with eligibility reporting, and it is easy to understand why many practices have a problem with staying current and optimizing the various tools offered to them. I link it to taxes – tax accountants are paid to stay current with everything and so increase the return to each customer.
Exactly the same can probably be said for medi-cal eligibility verification system. You will find specialists you are able to outsource to, ultimately optimizing the procedure for that practice. For people who maintain the eligibility in-house, don’t overlook proven methods. Adhere to these tips to help guarantee get it right each time and reduce the chance of insurance claim issues and improve your revenue.
Top 5 Overlooked Methods Seen to Increase the Efficiency, Accuracy of Eligibility Verification.
1) Verifying existing and new patient eligibility every single visit: New and existing patients must have their eligibility verified Every. Single. Visit. Quite often, practices usually do not re-verify existing patient information because it’s assumed their qualifying information will stay the same. Incorrect. Change of employment, change of insurance coverage or company, services and maximum benefits met can alter eligibility.
2) Assuring accurate and complete patient information: Mistakes can be produced in data entry when someone is wanting to get speedy in the interests of efficiency. Including the slightest inaccuracy in patient information submitted for eligibility verification can cause a domino effect of issues. Triple checking the precision of the eligibility entries will seem like it wastes time, however it helps you to save time over time saving practice managers from unnecessary insurance provider calls and follow-up. Ensure that you possess the patient’s name spelling, birth date, policy number and relationship for the insured correct (just to name a few).
3) Choosing wisely when based on clearing houses: While clearing houses can provide fast access to eligibility information, they usually usually do not offer all necessary information to accurately verify a patient’s eligibility. More often than not, a call made to an agent in an insurance carrier is important to assemble all needed eligibility information.
4) Knowing precisely what an individual owes before they can reach the appointment: You need to know and be ready to advise a patient on the exact amount they owe to get a visit before they even can reach the office. This will save money and time for a practice, freeing staff from lengthy billing processes, accounts receivable follow-up and also enlisting the aid of cgigcm bureaus to accumulate on balances owed.
5) Having a verification template specific for the office’s/physician’s specialty. Defined and specific questions for coverage pertaining to your specialty of practice will certainly be a major help. Not all specialties are the same, nor could they be treated the same by insurance company requirements and coverage for claims and billing.
While we said, it’s practically impossible for those practice operations to run smoothly. There are inevitable pitfalls and areas susceptible to issues. It is essential to begin a defined workflow plan which includes mix of technology and outsourcing if needed to attain 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. 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. When the verification is carried out the coverage facts are put directly into the appointment scheduler for the office staff’s notification.