Top 5 Best Practices In Patient Eligibility And Benefits Verification
Prior to treatment, medical care providers must verify all of their patients' insurance coverages and benefits. This practice eliminates the possibility of making mistakes when filing for insurance reimbursements. An effective process for verifying patients' insurance eligibility helps to improve insurance payments while reducing the risk of claim rejections and delayed payments.
While
the process of verifying patients' eligibility is time-consuming, it also
necessitates skilled execution. The entire process is divided into stages, each
of which requires expert intervention to obtain the desired results and
optimize the output.
Here
are the best practices for making the patient
eligibility verification process more efficient and faster:
·
Gather data from everywhere:
The
collection, analysis, and utilization of all possible methods to verify
appropriate insurance coverage were required for patients' eligibility
verification. The key component in this case is data. You must identify all
sources of accurate information about patients and their insurance plans. This
can begin with recording information about the patient's demography, insurance
coverage, type of plan, date of commencement and expiry, the status of plans,
information about copays and deductibles, patient responsibility, and insurance
reimbursements.
·
Perform a thorough data check:
The
data needed for the eligibility verification process must be accurate and up to
date. A thorough examination of all data pertaining to these two aspects is
required. The use of outdated, incorrect, or missing data can jeopardize the
process's success. When such data is presented to an insurance company, it is
either immediately rejected or held over for extended periods of time,
resulting in financial loss and an impact on account receivables.
·
Verify Eligibility at the Appropriate Time (s)
In
addition to determining the best verification method for your practice, it is
critical to ensure that your staff is verifying patient eligibility at the
appropriate time(s) and to establish a routine batch verification schedule.
Though your practice should find a schedule that works for your staff and your
needs, there are a few occasions when eligibility tests are typically
recommended.
When
on the phone with a patient, the most common recommendation is to schedule an
appointment. This gives you time to correct any errors or gaps in coverage
before the patient arrives, avoiding the awkward situation of explaining why
the physician is unable to see the patient. It's also a good idea to
double-check their insurance information when they arrive, as insurance plans
can change in a matter of days.
·
Reiterate Payment Obligation at Check-In
If
you train your staff to verify eligibility and calculate price estimates for
patients over the phone when scheduling appointments, it's still important to
remind them of their financial responsibility. It is also crucial to remind the
staff what copay they need to offer, for example. your practice should also
have a written patient payments policy available to patients, either in the
office or on your website, that can answer billing-related questions for
patients.
·
Examine the patients' knowledge of their insurance plans:
It
is critical to determine how well the patient understands his insurance plans,
coverage, and responsibilities. Several times, it has been observed that
patients are completely unaware of the changes introduced by the insurance
provider. When such surprises occur during the payment process, and the patient
is left paying large sums out of pocket, the relationship and trust between the
patient and service provider suffer. To overcome this, the provider must inform
the patient about the out-of-pocket
costs prior to treatment.
Seek
Professional Advice!!
The
verification process is best carried out by experts. You can outsource this
task to professionals of 24/7 Medical Billing Services while focusing your
staff on other areas that require more focus and attention. The subject matter
experts are capable of handling every stage of the insurance verification
process with clarity, confidence, and competence. Professionals with experience
dealing with multiple clients can better identify gaps and find better
solutions to resolve issues faster.
About
24/7 Medical Billing Services:
We
are a medical billing company that offers ‘24/7
Medical Billing Services’ and support physicians, hospitals, medical
institutions and group practices with our end to end medical billing solutions.
We help you earn more revenue with our quick and affordable services. Our
customized Revenue Cycle Management (RCM) solutions allow physicians to attract
additional revenue and reduce administrative burden or losses.
Contact:
24/7
Medical Billing Services
Tel:
+1 888-502-0537
Comments
Post a Comment