Patient eligibility verification involves confirming that the info on the insurance identification card brought by patients during an office visit is up-to-date and accurate and checking their coverage at the time of service.
On the second note it’s very important that you gather the correct information of the patient and the insurance as well. The correct information of the patient will include the Full name, DOB, Age, Race, Sex, Residing Address etc. and the name of the insurance company with which the patient is enrolled. For the correct information you can ask for the patient’s insurance card or the driving’s license.
Another important factor is the ratio of patient volume to the office staff i.e.: whether your practice can handle the flow of the patients effectively or not. In this scenario timings are also very important. If your practice is having work load of patients from let’s say 10AM till 7PM and your staff is free after 04 or 05, then insurance verification is not possible on call as most of insurance companies close at 05:00 PM.
If the patient volume is much then you can put a dedicated person for this role of eligibility verification so that the services don’t get compromised while performing concurrent tasks.
It is also important here that there are different resources for checking the insurance statuses of the patients. Some 80% of the insurances have their web portals, you can just get a username and password and check the eligibility from there. Calling insurances is also an option, the calls could be live on through IVR. You can just ask for the requirement and the insurances can send you the faxes or the e-mails for the eligibility of the required patients.
Now a days there are many integrated system for different softwares and the insurance companies. They are linked together and you can just get the eligibility details of the patients through one click option. This option is sometimes paid and sometimes it’s free.
In this whole process cash stream is very important. It can help you determine the cash flows. If a service has been provided at your facility and the bill has been paid, there is certain amount at patient’s end which you can ask patient to pay. After 30 days if the amount is not paid then it will be referred as bad debts.
HQ Analytics helps your practice perform eligibility verification before every appointment to reduce claim denials and improve time-of-service collections. We can make calls to payers or visit multiple websites of payers on your behalf to confirm coverage.
Our Eligibility Verification Services
• Obtain patient schedules from the hospital or clinic via FTP, fax or e-mail
• Demographic information entry or update
• Verify coverage on all primary and secondary payers
• Confirm authorization for treatment from appropriate sources, if applicable
• Update the billing system with verified details
Get a Free Trial today. Our services help you to reduce A/R cycle and improve collections.
Insurance Verification for Practices of All Sizes
With our customized solutions, we verify coverage details for practices of all sizes such as primary care providers, specialists, and group practices. We have insurance verification specialists with extensive knowledge regarding the specific needs of practices.
Key Benefits
With our dedicated services, we provide you with the following benefits:
• System-based eligibility checking
• Regular QA checking with readily available reports
• Daily, monthly and weekly reports
• Customized TAT
• No long term yearly contracts
With our medical eligibility verification method, you can enjoy minimized overhead costs with 30% to 40% cost savings. Dial 212-470-1500 today to speak to our billing representative about your requirements and discuss how we can help your practice.
May 19, 2019EligibilityMedical Insurance