Insurance Eligibility Verification An advantage For Easier Collections3282095

From Mu Origin Wiki
Jump to: navigation, search

What's Insurance Eligibility Verification?

Insurance Eligibility Verification is the method of obtaining the insurance policy status of your patient so that you can minimize errors in medical claims processing information in order to avoid delays in revenue cycle management. In addition, it provides information beforehand about the patient's insurance policy, co-pays and deductibles along with services that aren't covered for a specific specialty.


Need for Insurance Eligibility Verification:

Today, the patients suffer a great deal because of the major drawbacks within the eligibility and benefit verifications processes then 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 rather crucial that you have the medi cal eligibility check refrained from any delay. Furthermore, the greatest advantage to the patients plus the providers is they are both ready by what is included and what's to not determine the best plan of care. The verification can be carried out by 50 percent ways - using a call towards the Insurance carrier (payer) or via websites (payer or EDI). By using Insurance Eligibility Verification, revenue cycle management could be improved up to four times by reducing the number of rejected medical claims and increasing the flow of cash. Online verification saves a lot more some time and facilitates collection of estimated patient payments in advance during hospital visit saving patients from 'Balance due' statements Three to six months later. Last but not the least, the efficiency and productivity of personnel at healthcare entities can also be improved by an effective insurance eligibility verification process.

How Insurance Eligibility Verification works?

There are 2 types of Eligibility verifications. The first can be a basic verification which gets basic coverage specifics of the individual in addition to the co-pay and deductible details. Second is much more in-depth and requires the gathering of 'code specific' eligibility with annual max or lifetime max limits. The second kind of verification is very useful for a number of the 'super specialties' like Cardiology, Nephrology, Urology, Chiropractice, Gastroenterology, General Surgery, Physical Therapy etc. The main advantage is incorporated 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 which was obtained prior to the patient's visit.

Effect on Collections:

As explained earlier, the largest impact of your thorough Eligibility Verification is on the revenue cycle management. Many Providers ignore Eligibility being a waste of cash and effort. But, when they adopt this process, lots of time may be saved during the revenue cycle management leading to faster medical claims processing that will deliver substantially better Collections than their current levels.