The unexpected errors in the Patient eligibility verification process are the major reasons for medical billing denial from the payers. However, the surveys have proved that these rejections could be prevented with little effort and care.
By establishing a solid process for verifying medical insurance eligibility and conducting checks at multiple points during the patient’s journey, you can easily reduce the rejection rate and speed up payments
But the million-dollar question is, what steps are required to achieve this feat?
Today, we will discuss the top 5 tips that will help you enhance your verification process and achieve a nearly 100% success rate.
Top 4 Tips to Achieve 100% Success Rate in Patient Insurance Verification
Streamline Insurance Claims with Pre-Registration Eligibility Verification
The best practice to strengthen the medical billing insurance claim process is to get the essential information 1-3 days before the patient’s appointment. This practice will be useful in understanding the patient’s eligibility before an appointment.
For an effective pre-registration eligibility verification process, ensure your organization has the appointment-setting communication tool that could be critical in collecting information ahead of time.
So, what must be included in the checklist to ensure that you have all the necessary information that will be helpful to complete the eligibility verification?
The following is the basic information that every healthcare institution must get before the patient’s appointment.
- Patient’s full name, date of birth, home address, and contact number
- Insurance company name, its phone number, and claims processing address
- Insurance coverage details, such as policy and group identification numbers
- Information about any secondary insurance, if relevant
- Name of the person covered by the insurance and details regarding dependents
- The date the insurance policy took effect
- The expiration date of the insurance policy
- Confirmation that the proposed procedure or service is included in the coverage
- Details regarding the policy’s limitations, including any exclusions or documentation requirements
Advise All Patients to Bring Insurance Cards to Each Visit
After you successfully collect the required information, the healthcare providers now can contact the insurance company for the verification of patient details and the patient policy even before his first appointment.
Why is it necessary?
Well, if you see there is a contradiction between the information you collect and the insurance company, you will have enough time to resolve the issue before the time of appointment.
Reconfirm Insurance Details Before Every Scheduled Appointment
The verification process is crucial and should always begin with the thorough collection, examination, and confirmation of patient information. This practice is essential for both new and returning patients. Here’s what you should do each time a patient arrives for their appointment:
- Request Their Insurance Card: For new patients, verify their insurance information against the details collected during the pre-intake process. If there were any discrepancies or issues during the medical eligibility check, be sure to seek clarification directly from the patient.
- Collect Insurance Cards from Existing Patients: It’s important to gather insurance cards from returning patients to check for any updates in their policies or demographic details. Remember, nearly one-third of patients change employers annually, which can lead to changes in their insurance coverage.
Make a Copy of the Insurance Card: Keeping an up-to-date copy of the insurance card on file serves as a reliable backup and ensures you have accurate information documented. This allows for easy cross-checking of the patient’s details during their next visit.
Contact the Insurance Provider
When you successfully collect the patient’s information, it’s time to move to the insurance company to verify that the information provided by the patient is accurate and correct. This proactive and advance approach allows the healthcare providers to resolve any problem that could arise after submitting the claim. Facing denial after submitting the claim is a real headache for healthcare providers.
Therefore, Contacting the insurance providers or payers before submitting it is an ideal scenario.
We all know that the patient verification process takes too much time and resources and when you have to verify it over the phone it becomes a real headache.
To avoid such problems, automate your verification process. If you do not have such a verification process in place, there is still no need to worry about it.
Scribe Runner’s advanced automotive verification services make it quite easy to submit with an almost 100 percent success rate. By adopting Scribe Runner’s automatic verification process, you not only lighten the load for your billing staff but also speed up the payment process, helping your practice maintain a healthy cash flow.
Looking for Assistance in Achieving 100% Patient Verification?
Submitting an insurance claim is a time-consuming task that often lets you compromise on your other administrative tasks or patient care. Why spend too much time, and resources on the in-house team hiring process and then on training and equipment, when you have the opportunity to achieve a higher success rate at 50% less cost?
With Scribe Runner’s advanced patient verification process, you can significantly reduce denial rates and boost your revenue and growth. Say goodbye to frustrating denials and hello to a more efficient and streamlined approach to insurance claims. Embrace the future of patient verification, and let Scribe Runner help you focus on what truly matters: delivering exceptional care to your patients