Daniel Kahneman in his book “Thinking, Fast and Slow” concludes that a little assurance makes humans feel secure and protected whether in personal life or Business Dealings.
Just like this, healthcare Providers have to do verification at multiple stages. And among all their verification the main focus always remains on the eligibility and verification services.
In simplest terms, eligibility and benefits services are about verifying the eligibility of a patient’s insurance, and these services are handled by medical billing experts.
This service gives peace of mind to the medical services providers that a patient’s insurance coverage and benefits are accurate and eligible before any medical services are provided to them.
However, in the ever-challenging landscape of insurance policies and plans, these verification services play a vital role in revenue cycle management services.
In this blog we will be discussing the benefits of eligibility and benefits verification, what are the best practices for them, and how they can be helpful for both patients and healthcare providers. But before diving deeper, let’s first understand what exactly eligibility criteria and benefits verification entail.
What is Eligibility and benefits verification?
Eligibility and Benefits Verification is all about making sure that a patient’s insurance details are accurate and up-to-date, so everyone knows exactly what services are covered. This step is essential for healthcare providers to avoid mistakes and ensure patients aren’t hit with unexpected bills after their treatment.
During this process, healthcare providers check important details like the patient’s insurance number, the insurer’s name, the type of plan (whether it’s PPO, HMO, etc.), and specifics like co-pays, coinsurance rates, and deductibles.
All this information helps confirm whether a patient qualifies for certain services and what costs might come out of their pocket. But with how complicated and constantly changing insurance policies can be, eligibility and benefits verification have become tougher than ever.
Keeping up with these changes is crucial to avoid claim denials, and payment delays, and, ultimately, to prevent dissatisfaction and potential revenue loss for healthcare facilities.
Why is Eligibility and Benefits Verification Important?
- Avoid Claim Rejections: A common issue many medical practices face is claim rejections due to incomplete or inaccurate insurance information. When a claim is rejected, it not only delays payment but also increases administrative costs to fix the mistake. By conducting eligibility and benefits verification upfront, you can prevent these claim rejections and ensure timely reimbursement.
- Enhance Cash Flow: Verifying eligibility and benefits can help improve cash flow by reducing the number of unprocessed claims and rejections. Checking a patient’s insurance coverage and benefits before services are provided allows you to know the expected payment amount and whether those services are covered by the patient’s health plan.
- Boost Patient Satisfaction: Providing transparency about insurance coverage and out-of-pocket costs upfront can improve patient satisfaction. When patients know their financial obligations ahead of time, they are more likely to feel that the billing process is fair and transparent.
- Streamline Operations: Verifying eligibility and benefits also helps streamline operations and reduce administrative costs. Automating this process with technology reduces errors and frees up staff to focus on other critical tasks.
Benefits of Outsourcing Eligibility and Benefits Verification to ScribeRunner
As a medical practice, it’s important to ensure proper reimbursement and effective revenue cycle management. However, eligibility and benefits verification can be a complex and time-consuming process. That’s where we come in.
Scribe Runner offers top-tier eligibility and benefits verification services for medical practices. Here’s why it works:
- Experience and Expertise: Our team is highly trained in navigating insurance plans, copays, coverage issues, and benefits. We verify a patient’s eligibility and benefits quickly and accurately, reducing errors that lead to claim rejections.
- Advanced Technology: Our cutting-edge technology streamlines the verification process, reducing administrative costs and increasing efficiency. This automation means less time and fewer resources are needed on your end.
- Cost Savings: Outsourcing to us can save your practice money by eliminating the need for an in-house team to handle identity proofing and verification, reducing labor costs, and avoiding expensive software and technology.
- Improved Cash Flow: Our services help enhance cash flow by reducing claim rejections and denials. Verifying patient insurance information upfront minimizes unpaid claims and denials.
- Scalable Solutions: Our service is scalable to meet the needs of your growing practice. As your practice expands, the verification process can become more complex and time-consuming. We can scale up the verification process quickly without the need for additional staff or resources.
Summing It Up
Outsourcing eligibility and benefits verification can be highly beneficial for medical practices. With the support of a specialized service provider, practices can improve cash flow, reduce costs, and focus on what truly matters – patient care. Consider outsourcing as a viable option to maintain your practice’s financial health.
At Scriberunner, we understand the importance of eligibility and benefits verification in revenue cycle management. That’s why we offer the best service to help your medical practice receive proper reimbursement and focus on patient care. Contact us today to learn more about how we can support your practice.