Medi-Cal Eligibility Verification System – Does It Be Much Better Than This..

Changing policies. New forms. Added steps to the process. Pick any of these, yet alone the longer laundry list of the difficulties related to eligibility reporting, and it’s understandable why many practices battle with staying current and optimizing the various tools available to them. I correlate it to taxes – tax accountants are paid to stay current with everything and thus maximize the return to each customer.

The same can be said for medical insurance eligibility verification. There are specialists you are able to outsource to, ultimately optimizing the process for your practice. For individuals who keep up with the eligibility in-house, don’t overlook proven methods. Adhere to these guidelines to help assure you get it right every time and reduce the chance of insurance claim issues and improve your revenue.

Top 5 Overlooked Methods Proven to Boost the Efficiency, Accuracy of Eligibility Verification.

1) Verifying existing and new patient eligibility each and every visit: New and existing patients should have their eligibility verified Every. Single. Visit. Quite often, practices do not re-verify existing patient information because it’s assumed their qualifying information will remain the same. Untrue. Change of employment, change of insurance policy coverage or company, services and maximum benefits met can alter eligibility.

2) Assuring accurate and finish patient information: Mistakes can be produced in data entry when someone is wanting to become speedy in the interests of efficiency. Even the slightest inaccuracy in patient information submitted for eligibility verification could cause a domino effect of issues. Triple checking the precision of the eligibility entries will appear to be it wastes time, nevertheless it can save time in the long run saving practice managers from unnecessary insurance provider calls and follow-up. Be sure that you have the patient’s name spelling, birth date, policy number and relationship for the insured correct (just to name a few).

3) Choosing wisely when according to clearing houses: While clearing houses can provide fast access to eligibility information, they normally tend not to offer all information you need to accurately verify a patient’s eligibility. More often than not, a telephone call designed to a representative at an insurance company is important to assemble all needed eligibility information.

4) Knowing precisely what the patient owes before they even reach the appointment: You should know and be ready to advise a patient on the exact amount they owe for any visit before they even can arrive at the office. This can save time and money to get a practice, freeing staff from lengthy billing processes, accounts receivable follow-up as well as enlisting the assistance of cgigcm bureaus to gather on balances owed.

5) Possessing a verification template specific for the office’s/physician’s specialty. Defined and particular questions for coverage related to your specialty of practice is a major help. Its not all specialties are the same, nor will they be treated exactly the same by insurance carrier requirements and coverage for claims and billing.

Since we said, it’s practically impossible for those practice operations to perform smoothly. You can find inevitable pitfalls and areas vulnerable to issues. It is essential to begin a defined workflow plan that also includes mix of technology and outsourcing if necessary to attain consistency and accountability.

We are a healthcare services company providing outsourcing and back office solutions for medical billing companies, medical offices, hospital billing departments, and hospital medical records departments. We offer Eligibility Verification for preventing insurance claim denials. Our service starts off with retrieving a list of scheduled appointments and verifying insurance coverage for your patients. Once the verification is performed the coverage data is put straight into the appointment scheduler for the office staff’s notification.