Patient eligibility test is a vital part of medical billing for every healthcare process. It helps you determine if the patient’s insurance covers the treatment and medication they are going to receive. This process ensures that the provider will get reimbursed for every service they provide so that the patient receives quality care.
With regular changes in the medical billing industry, keeping up with the changes can be challenging. The provisions and guidelines change so frequently that organizations need to have a separate guy who looks after only the changes in guidelines.
In this blog we will learn about the importance of eligibility and benefits verification along with the impact it has on patient experience and the organization’s revenue cycle management
We will go through the benefits of eligibility verifications like reducing claim rejections, improved patient satisfaction and enhanced revenue. We will also learn about some of the best practices for eligibility verification such as fostering technology and outsourcing your medical billing to streamline the process and minimize errors.
What is Eligibility and Benefits Verification
The process of verifying a patient’s health insurance coverage and benefits to determine the covered services and treatments is known as eligibility and benefits verification. It is an important element in the medical billing process as it can help the practitioner, and the patient understand the breakage of the total amount.
This process makes sure that the practitioner gets reimbursed properly and the patient is not left with any unexpected bills.
During the verification process healthcare providers collect information such as patient’s insurance, policy number, type of plan, name of the insurance company, patient’s co-payment, coinsurance and deductible amounts.
This information is then used to verify if the patient is eligible for medical services and determine if the treatment or service is covered by insurance or not. It also allows the practitioner to inform the patient about their financial responsibility.
Eligibility verification is a complex task because of the ever-changing landscape of insurance in the medical billing process. All the healthcare providers must be up to date with the latest guidelines and regulations. If eligibility is not checked beforehand it can result in claim denials, delayed payments, unsatisfied patients, and loss of revenue.
Importance of Eligibility & Verification
The eligibility and verification process is very vital in medical bill processing. It has a significant impact on the revenue cycle. As a medical practitioner it becomes essential to conduct a full-fledged eligibility and verification test so that the patient can be given appropriate treatment.
Let's understand how it helps claim submission process in medical billing.
Avoid Claim Rejections
One of the biggest issues that medical practitioners face is claim rejections. This can happen due to multiple reasons such as incorrect or incomplete patient information.
Once a claim is rejected it can delay the payment which results in additional administrative costs to correct the errors. Once you conduct an eligibility verification test, you can avoid these claim rejections and ensure timely reimbursements for the services rendered.
Improved Cash Flow
Eligibility and verification improve cash flow by decreasing the number of unpaid claims and denials. Once you verify a patient’s insurance coverage and benefits before providing medical assistance, you can determine the expected cash flow from the patient and the insurance company’s side.
You can also ensure that the services you are providing are covered by insurance.
Enhanced Patient Satisfaction
Once you do the eligibility and verification tests, it allows the patient to know about the status of their insurance policy. This lets the patient know what treatments and services are covered under their insurance and what needs to be paid by the patient.
Patients who are well informed about their out-of-pocket expenses feel more satisfied with the treatment. It showcases that you are transparent, and the patient can trust you.
Streamline Operations
Once eligibility verification is done it helps you streamline the entire operation and reduce the administrative costs. You can automate the verification process by utilizing technology. It reduces the errors significantly, which saves a lot of time and effort for your staff. This energy can be directed towards providing better patient care.
Benefits of Outsourcing Eligibility & Verification
Ensuring proper reimbursement is a crucial element of revenue cycle management for any organization. However, it is a time consuming and hectic task which requires huge amounts of substantial resources
This is where Unify Healthcare Services will help you lessen the burden.
How? Let's understand!
Expertise & Knowledge
Unify Healthcare Services has a team of experts who are highly trained and experienced to handle the complexities of insurance plans, benefits and coverages. The experts can verify a patient’s eligibility benefits quickly and accurately reducing errors and claim denials.
Innovative Technology
A well-established medical billing company is always up to date with technology. They use technology to streamline the verification process which lowers administrative expenses and improves efficiency. Automation can really do wonders like you would have never imagined.
Cost Savings
Once you outsource your eligibility verification process, it will lead to huge cost and effort savings for you and your staff. It eliminates the need for in-house staff required to handle the verification process.
This cuts down labor costs and avoids the need for expensive software and technology for your medical billing process.
Improved Cash Flow
A smooth and hassle-free verification process means improved cash flow by reducing the number of claim rejections and denials. The likelihood of unpaid claims and denials decreases significantly once you verify patient insurance information beforehand.
Bottomline
Eligibility verification plays an important role in medical bill processing. However, taking into account the complexity, it is understandable that not every healthcare organization has the resources to manage everything in-house.
This is where medical billing companies like Unify Healthcare solution comes in.
Unify Healthcare Services has a long list of clients who have seen a massive boost in their revenue after they took the services. It is a well-established organization which takes a lot of burden away from your shoulders.
You can also ask for tailored services designed specifically for your organization. It will streamline the process and make eligibility verification hassle-free.
Unify Healthcare Services envisions making medical billing process easy and convenient for everybody so that the providers can get paid timely, and they can provide quality care with a free mind.
