Insurance Eligibility Verification An advantage For Easier Collections8608846

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What exactly is Insurance Eligibility Verification?

Insurance Eligibility Verification is the process of obtaining the insurance coverage status of the 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 in regards to 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 whole lot because of the major drawbacks in the eligibility and benefit verifications processes accompanied by many healthcare providers. The healthcare providers lose considerable 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 right physician, it is rather vital that you obtain the check medical eligibility kept away from any delay. Additionally, the largest benefit to the patients along with the providers is they are both ready in what is protected and what is not to determine the very best plan of care. The verification can be carried out in 2 ways - via a call towards the Insurance carrier (payer) or via websites (payer or EDI). By using Insurance Eligibility Verification, revenue cycle management can be improved approximately 4 times by reduction of the number of rejected medical claims and increasing the flow of income. Online verification saves even more some time and facilitates collection of estimated patient payments beforehand at the time of hospital visit saving patients from 'Balance due' statements 3 to 6 months later. Last however, not the least, the productivity and efficiency of staff members at healthcare entities can be improved by an efficient insurance eligibility verification process.

How Insurance Eligibility Verification works?

There are two kinds of Eligibility verifications. The first one can be a basic verification which gets basic coverage information on the patient as well as the co-pay and deductible details. Second is far more in-depth and necessitates the gathering of 'code specific' eligibility with annual max or lifetime max limits. The 2nd type of verification is quite helpful for some of the 'super specialties' like Cardiology, Nephrology, Urology, Chiropractice, Gastroenterology, General Surgery, Physical Therapy etc. The main advantage is within the revenue cycle management and collections, in which a medical claims processing rejection can be disputed with all the payer based on the eligibility information that has been obtained ahead of the patient's visit.

Impact on Collections:

As explained earlier, the greatest impact of a thorough Eligibility Verification is around the revenue cycle management. Many Providers ignore Eligibility like a waste of money and effort. But, if they adopt this method, considerable time can be saved through the revenue cycle management resulting in faster medical claims processing that might deliver substantially better Collections than their current levels.