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Enable accurate collections with insurance eligibility verification

Medical Billing

Reducing the Administrative Burden of EHRs | AdvancedMD

With the increasing number of insurance plans, healthcare providers are driven to increasing accuracy in their health insurance eligibility verification process. As it has become a necessity, failing to attain proper eligibility verification can lead to unpaid and delayed claims. This will in turn effect the revenue cycle, thereby impacting the profitability of the healthcare practice.

That being said, even with an in-house verification team it gets difficult to maintain accuracy for practices for various reasons. It is sometimes best to outsource eligibility verification to the hands of a third-party expert. For the healthcare sector, it is a well-known fact that the insurance verification process is a long and tedious process that requires lot of time, effort, and accuracy. And for the same reason, practices cannot immerse their resources into eligibility verification while they must focus on giving the best patient care.

The increase in out-of-pocket expenses has led patients to not fulfill their financial responsibilities, which in turn has impacted collections for practices across the country. And, this has pushed healthcare providers to restructure their eligibility verification process in order to manage their practice expenses and remain relevant for the services they offer.

How to improve collections with eligibility verification (EV)?

In order to stay financially viable, healthcare practices must focus more on patient flow and come up with strategies to optimize their eligibility verification process. They also include staying away from processes that take up their valuable time. What should they do instead? Practices can turn to well-established and efficient billing companies to get the desired result without having to compromise their primary goal of patient care.

Not just that, reliable RCM companies offer an extensive range of services including credentialing, prior authorization, contract negotiations, insurance verifications, and such and help enhance practice revenue.

In order to enhance the practice collections, the RCM managers must ensure that the following three points are covered effectively:

  1. Quick Document Verification:

Medical billing companies must ensure that they thoroughly inspect the required documents as soon as they receive it from a healthcare facility. To complete the initial stage of determining insurance eligibility, they must compare it to the list of papers needed for verification.

  1. Automated Insurance Verification Process:

Automation is a boon. Leveraging the right software and tools will not only help with the processing but also bringing in effective revenue when it comes to healthcare organizations. Medical billing service providers can swiftly verify a patient’s insurance coverage, thanks to the online insurance portals. If not, they frequently get in touch with the patient personally anytime.

  1. Proper Patient Follow Up:

In the event that any of the provided information is incomplete or wrong, medical billing service providers can always communicate with the patients and cross check the details. This will help enable an error-free insurance eligibility process and also increase the transparency across the entire process.

How does insurance eligibility verification process help enhance practice revenue?

With outsourced RCM services, medical practices can maximize their revenue because of several reasons. Let us look into some:

  • Claim processing is sped up by the availability of updated eligibility data. This guarantees that there will be a steady flow of cash for healthcare businesses.
  • Since eligibility responses are periodically analyzed, the entire process is run more efficiently, improving the patient experience.
  • By automatically comparing databases with patients who pay for their own care, it also aids in increased compensation for healthcare professionals.

Verifying insurance eligibility is essential to a reliable and well-structured medical billing system. Most claim delays are the result of patients supplying inaccurate information. The healthcare staff frequently forgets to update the data, which directly affects your healthcare facility’s ability to access speedy cash flow. Therefore, it is imperative that you outsource medical billing to provide the impression that this process is straightforward to both patients and staff.

Physicians now routinely outsource their billing needs to a medical billing service company. In addition to the other benefits, eligibility and benefits verification services makes determining insurance coverage simple, easy, and hassle-free.

Practolytics logo
Practolytics partnered with AdvancedMD in 2013 to create a one-stop solution for all the medical billing, practice management, patient management, and revenue cycle management activities a healthcare practice need to carry out. A Platinum partner amongst 850+ billing companies, Practolytics is a 20+ year-old healthcare technology and revenue cycle management services company providing medical billing service solutions to 180+ practices of all sizes spreading across 31 states and serving more than 28 critical specialties. Practolytics with support from AdvancedMD billing software processes more than 2.5M claims annually, collecting more than $500M for its clients. End-to-end services include medical billing, medical coding, chart audit, credentialing, eligibility, benefits verification, and preauthorization services. The company’s diverse background in every aspect of healthcare allows it to maximize revenue and consistently deliver optimum results.

Topic: Medical Billing

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