Insurance Eligibility Verification A benefit For Easier Collections5988164

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What is Insurance Eligibility Verification?

Insurance Eligibility Verification is the procedure of obtaining the insurance status of a patient so that you can minimize errors in medical claims processing information to prevent delays in revenue cycle management. Additionally, it provides information beforehand concerning the patient's insurance plan, co-pays and deductibles in addition to services which are not covered for a particular specialty.


Importance of Insurance Eligibility Verification:

Today, the patients suffer a great deal as a result of major drawbacks within the eligibility and benefit verifications processes then many healthcare providers. The healthcare providers lose lots of time and financial capital in delays because of time taken for medical claims processing and rejections. Therefore, to be able to streamline the access of patients to the right physician, it is extremely vital that you have the check medical eligibility done without any delay. Furthermore, the greatest benefits of the patients as well as the providers is that they tend to be ready by what is covered and what is to not determine the most effective plan of care. The verification can be done in two ways - by way of a call towards the Insurance Company (payer) or via websites (payer or EDI). With the help of Insurance Eligibility Verification, revenue cycle management could be improved approximately four times by lessening the amount of rejected medical claims and increasing the flow of money. Online verification saves a lot more serious amounts of facilitates collection of estimated patient payments beforehand at the time of hospital visit saving patients from 'Balance due' statements Three to six months later. Last although not the least, the productivity and efficiency of personnel at healthcare entities can also be improved by a highly effective insurance eligibility verification process.

How Insurance Eligibility Verification works?

There's two forms of Eligibility verifications. The first is really a basic verification that gets basic coverage information on the individual as well as the co-pay and deductible details. The second reason is much more in-depth and involves the gathering of 'code specific' eligibility with annual max or lifetime max limits. The second form of verification is quite helpful for a number of the 'super specialties' like Cardiology, Nephrology, Urology, Chiropractice, Gastroenterology, General Surgery, Physical Therapy etc. The main advantage is in the revenue cycle management and collections, where a medical claims processing rejection could be disputed with all the payer in line with the eligibility information that has been obtained prior to the patient's visit.

Effect on Collections:

As explained earlier, the biggest impact of your thorough Eligibility Verification is about the revenue cycle management. Many Providers ignore Eligibility like a waste of money and. But, should they adopt this technique, considerable time could be saved during the revenue cycle management leading to faster medical claims processing that might deliver substantially better Collections than their current levels.