December 8, 2022
This guide will walk you through how eligibility verification can help speed up the medical billing workflow and reimbursements. We will also discuss the main reasons that result in claim denials, what steps the eligibility verification process should follow and what physicians should do. Besides, we will explain the benefits of getting an outsourced medical billing services to ensure a healthy revenue cycle.
Insurance verification is systematically getting in touch with the insurer to see whether the patient is eligible and whether their health insurance covers the necessary procedures.
The insurance verification procedure, which is the initial step in the medical billing process, covers plan exclusion, policy status, deductibles, and other items affecting cost and coverage. It is completed prior to patients being admitted to the hospital.
Skipping the insurance verification process could result in a patient being hit with unforeseen high medical costs or your practice receiving unpaid or denied health insurance claims from the insurance companies.
A recent study found that the procedure of verifying insurance cost healthcare providers 30% of their annual income on average. Verifying insurance claims before providing service can help unlock value and stop income leaks, ensuring a healthier revenue cycle.
The following are the leading causes of claim denials in the process of determining insurance eligibility:
These invariably lead to claim denials, non-payments, claim rework, delayed payments, and increased patient and provider expenses. As a result, the revenue decreases, while patients become dissatisfied with the medical practice. Additionally, in the age of YELP and Google reviews, it can also impact the provider's reputation.
Verifying insurance can improve the practice of medicine and make it safer, more rewarding, and more pleasant for your business. It can help address all of the following concerns effectively, ultimately making your healthcare facility more profitable with a steady cashflow:
Healthcare providers may prevent setbacks by working with the appropriate outsourcing partner to aid and support the claim process and guarantee seamless revenue cycle management.
The ideal partner would take care of the following activities:
Discussed below are some best practices for determining a patient's eligibility and benefits:
Bonus Tip: Social determinants of health are advancing healthcare fairness and access and are becoming a crucial component of care delivery. For Meaningful Use reporting, details like race, gender, ethnicity, birthdate, preferred language, etc., are essential.
You can get assistance from a professional medical billing company to take care of insurance verification, coding, and medical billing. Their tailored medical billing services enable you to hire experts for less money and lighten the pressure on your revenue cycle team. Some advantages of outsourcing include the following:
If you want to outsource your medical billing to the best medical billing company, look no further and schedule a demo with talkEHR.
This guide explored how insurance eligibility verification can help streamline medical billing and generate a steady cash flow. talkEHR’s medical billing services will provide you with complete revenue cycle support, reduce administrative burden, and increase your profitability by reducing the claim denial and rejection rate.