Insurance Eligibility Verification An advantage For Easier Collections4836278

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What exactly is Insurance Eligibility Verification?

Insurance Eligibility Verification is the procedure of obtaining the insurance status of the patient in order to minimize errors in medical claims processing information in order to avoid delays in revenue cycle management. Additionally, it provides information beforehand concerning the patient's insurance coverage, co-pays and deductibles along with services which are not covered for a particular specialty.


Significance of Insurance Eligibility Verification:

Today, the patients suffer a great deal because of the major drawbacks in the eligibility and benefit verifications processes followed by many healthcare providers. The healthcare providers lose a lot of time and financial capital in delays due to time taken for medical claims processing and rejections. Therefore, so that you can streamline the access of patients off to the right physician, it is very important to obtain the medi-cal eligibility verification kept away from any delay. Furthermore, the greatest benefits of both patients along with the providers is they tend to be prepared about what is protected what is actually never to determine the very best plan of care. The verification can be achieved in two ways - by way of a call to the Insurance Company (payer) or via websites (payer or EDI). With the aid of Insurance Eligibility Verification, revenue cycle management may be improved as much as four times by lessening the quantity of rejected medical claims and improving the flow of money. Online verification saves a lot more time and facilitates collection of estimated patient payments beforehand during hospital visit saving patients from 'Balance due' statements 3 to 5 months later. Last although not the least, the efficiency and productivity of personnel at healthcare entities may 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 one can be a basic verification that gets basic coverage details of the patient as well as the co-pay and deductible details. The second reason is a lot more in-depth and necessitates the gathering of 'code specific' eligibility with annual max or lifetime max limits. The 2nd type of verification is very ideal for a number of the 'super specialties' like Cardiology, Nephrology, Urology, Chiropractice, Gastroenterology, General Surgery, Physical Therapy etc. The major advantage is in the revenue cycle management and collections, where a medical claims processing rejection can be disputed with all the payer depending on the eligibility information that has been obtained before the patient's visit.

Impact on Collections:

As explained earlier, the biggest impact of your thorough Eligibility Verification is on the revenue cycle management. Many Providers ignore Eligibility as a waste of money and energy. But, when they adopt this method, considerable time could be saved throughout the revenue cycle management causing faster medical claims processing that would deliver substantially better Collections than their current levels.