Insurance Eligibility Verification An advantage For Easier Collections2817009

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What's 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 avoid delays in revenue cycle management. It also provides information beforehand in regards to the patient's insurance policy, co-pays and deductibles as well as services which are not covered for the specialty.


Significance of Insurance Eligibility Verification:

Today, the patients suffer a whole lot due to the major drawbacks in the eligibility and benefit verifications processes followed by many healthcare providers. The healthcare providers lose considerable time and financial capital in delays as a result of time taken for medical claims processing and rejections. Therefore, so that you can streamline the access of patients to the right physician, it is very important to get the medical eligibility verification done without any delay. In addition to this, the largest benefit to the patients along with the providers is they are generally ready by what is included and what is to not determine the very best plan of care. The verification can be carried out in 2 ways - using a call towards the Insurance Company (payer) or via websites (payer or EDI). With the help of Insurance Eligibility Verification, revenue cycle management may be improved approximately four times by reduction of the quantity of rejected medical claims and improving the flow of cash. Online verification saves even more some time and facilitates collection of estimated patient payments in advance at the time of hospital visit saving patients from 'Balance due' statements 3 to 5 months later. Last however, not the least, the efficiency and productivity of staff members at healthcare entities can be improved by an effective insurance eligibility verification process.

How Insurance Eligibility Verification works?

There are two types of Eligibility verifications. The first can be a basic verification that will get basic coverage information on the sufferer besides the co-pay and deductible details. The second reason is far more in-depth and necessitates the gathering of 'code specific' eligibility with annual max or lifetime max limits. The second kind of verification is very useful for some of the 'super specialties' like Cardiology, Nephrology, Urology, Chiropractice, Gastroenterology, General Surgery, Physical Therapy etc. The key advantage is within the revenue cycle management and collections, the place where a medical claims processing rejection may be disputed using the payer in line with the eligibility information that was obtained ahead of the patient's visit.

Effect on Collections:

As explained earlier, the largest impact of the thorough Eligibility Verification is around the revenue cycle management. Many Providers ignore Eligibility as a waste of income and effort. But, when they adopt this method, lots of time may be saved throughout the revenue cycle management causing faster medical claims processing that will deliver substantially better Collections than their current levels.