Insurance verification is a crucial element in upholding financial stability and operational efficiency in medical practices. It involves confirming patient insurance coverage details and eligibility before delivering medical services. Validating insurance information upfront allows you understand each patient’s insurance coverage and benefits. This helps prevent billing errors and claim denials.
the process of checking insurance coverage can be complex and time-consuming, causing inefficiencies and delays. Fortunately, companies providing insurance verification services have several proactive strategies in place to optimize efficiency, helping practices enhance their billing operations and improve overall productivity.
1. Find the Right Verification Method:
First off, every practice has unique needs, as well as resources, when it comes to eligibility verification. While more traditional practices like calling or faxing patient information to insurance providers might work for some smaller practices, other high-volume practices might find that tedious and time-consuming.
Other alternatives, as discussed in this article, include:
Carrier Portals, which are databases hosted on providers’ websites Clearinghouse Systems, databases hosted on third-party websites. Integrated Solutions, which are integrated into your practice management software Outsourcing, hiring a third-party to run eligibility tests for you, or purchasing verification automation software.
Regardless of which method you currently have, it’s important to ask yourself what your needs and resources are, and if there’s a better solution out there for you.
2. Verify Eligibility at the Right Time(s)
In addition to finding the right verification method for your practice, it’s also important to make sure that your staff is verifying patient eligibility at the right time(s) and to set a schedule for routine batch verifications.
3. Save Verification Information
Additionally, after you verify patient eligibility, save the information. Keep a record of the date and time as well as patient and staff information.Being proactive like this will prepare you for the unfortunate and annoying event of a dispute between you and a patient’s provider. If you outsource your verification processes or use automated verification software, make sure your vendor or software application saves this information as well.
4 . Regularly review and update patient information:
One of the most common causes of errors in patient eligibility verification is outdated or inaccurate patient information. By regularly reviewing and updating patient information, you can ensure that you have the most accurate information on file. This can help reduce errors and speed up the verification process. It is also important to train the staff on how to update patient information correctly and efficiently.
5. Train your staff
The very success of eligibility verification relies on the efficiency of your staff. Well-trained, well-informed, and experienced staff are an asset. Train your staff to maintain data hygiene by updating the data proactively rather than reactively. You will have a ready-to-use, reliable database instead of an error-prone one.
About M&M Claims Care:
M&M Claims Care is a unique service-oriented healthcare company that focuses on value-added solutions for ambitious health and wellness providers. We shine in the industry for unparalleled hands-on support, excellent development tools, and a pre-and post-development foundation unrivaled as a service-oriented partner – NOT just another technology company.
