Insurance eligibility verification is the initial and most significant step in the revenue cycle management process Without the eligibility verification process, it’s difficult to communicate with payers and determine the payer responsibilities. These difficulties can increase the number of errors during the claims submissions and also increase the average A/R days & lowers the business revenue. Let us discuss how to process insurance eligibility verification more efficiently.
Insurance Eligibility Verification
Insurance eligibility verification is the process of checking the patient’s insurance coverage status, eligibility status, etc. Here listed Below is the checklist of information to be verified for a smooth and productive billing of each claim. Type of Medicare coverage
- Coverage dates
- Patient demographics
- Benefit options – including patient responsibilities for co-pay, co-insurance & deductibles
- Individual plan deductible and deductible remaining
- Family plan deductible and deductible remaining
- Referrals and pre-authorizations
- Claims mailing address
- Lifetime maximum
- Address for claims submission
- In-network or out-of-network status
- Durable medical equipment coverage
Without verifying this information, healthcare services may be wrecked. Eligibility verification is of paramount importance as any deficiency may lead to claim denials and account receivables delays etc. The major reason for claims denials and delays is that insurance eligibility verification is not done accurately.
Optimize Insurance Eligibility Verification Process
Here are some of the techniques that can be followed to make the insurance verification process work effortlessly:
Check the patient’s insurance coverage with the payers by reaching the administrators through calls, Interactive Voice Response (IVR), and portals.
Updating e patient data accurately is essential. Our medical billing team gathers the patient details and gets the eligibility verification, claims details, etc. If any issues found during the eligibility verification process, the issue ought to be set out to avoid denials. Through the eligibility verification process, any miss in the patient data or the claims get updated and claims submitted error-free.
Outsourcing Makes Your Practice More Efficient
Outsourcing free up the workforce to focus on progressively productive tasks, and meanwhile improve payment and collections. The redistributed firm that you will work together with will focus on accelerating approval and co-ordinate with the insurance company concerning pending claims. Outsourcing engages you to have better control of your business. It will make your practice effective and ensure smooth working with staff and smoothed out a business process.
About e-care India
e-care India is the top medical billing outsourcing company in India. We specialize in Insurance eligibility verification. Our company has necessary security certifications including the SSAE 18, which is an added advantage. We have a Disaster Recovery Centre to make sure that business continues even during emergency times. To know more about e-care and its services, log on to www.ecareindia.com.