Easy Ways to Make Eligibility Verification Process Faster

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• Easy Ways to Make Eligibility Verification
  Process Faster

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Easy Ways to Make Eligibility Verification
Process Faster
Eligibility Verification Process is crucial in
healthcare revenue cycle management. Physicians
are responsible for eligibility verification of a
patient, every time whenever appointment is
scheduled. Importance of Insurance Eligibility
Verification Insurance verification is the
process of verifying a patients insurance in
terms of coverage status, status of policy
whether active or inactive, eligibility status.
This process is very important as it directly
affect to the claim status or delay in payment
from insurance of a healthcare practice.
Physicians can face such problems if eligibility
verification is not performed correctly. Accordin
g to many surveys conducted in healthcare
industry shows that two of the top five claim
denial reasons were insurance coverage
related. Under HIPAA, Health and Human Services
(HHS) implemented standards for electronic
transactions, including the health plan
eligibility verification. Ways to make
Eligibility Verification Process Faster The HIPAA
Eligibility Transaction System (HETS) is intended
to allow the issue of eligibility data to
Medicare Providers, Suppliers, or their
authorized billing agents for the purpose of
preparing an accurate Medicare claim, determining
Beneficiary liability or determining eligibility
for specific services.
Medical Billing Services in Oregon
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Easy Ways to Make Eligibility Verification
Process Faster

• Copy of Patients Insurance Card
• Physicians front end staff should be informed to
  take copy of patients insurance card for each
  date of service. This updated copy of both sides
  of insurance card in your EHR system can help
  billing team to verify typing mistakes of name or
  insurance details in CMS1500 claim form.
• Get the Information from Insurance Provider
• Insurance Eligibility Verification process can be
  carried out via a phone call to the respected
  insurance company, via insurance company website
  (payer or EDI) or medical billing software.
  Nowadays, many medical billing software has
  insurance eligibility verification process
  functionality.
• Verify below listed patient information from
  Insurance
• Co-Pays
• Co-insurances
• Payable benefits
• Deductibles
• Policy effective date
• Type of plan and coverage information
• Exclusions if any
• Mailing address

Medical Billing Services in Oregon
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Easy Ways to Make Eligibility Verification
Process Faster

• Referrals and Pre-Authorizations
• Many times, physicians verify insurance
  eligibility of patient for primary insurance.
  Its necessary to verify patients coverage on
  all primary and secondary payers.
• Update EHR / Medical Billing Software
• Physicians or Hospitals should have trained staff
  to take extra effort while capturing patients
  insurance card details into medical billing
  software. This information can build foundation
  of medical billing claim. Do not rush while
  conducting verification process, this can avoid
  data errors which might cause of denial of claims
  and delay in payments or the claims are not paid
  by insurance company.
• Contact Patient if required
• Once you get the all information from the
  insurance company you can contact patient to make
  him aware about his eligibility. If there is any
  concerns or questions while doing eligibility
  verification process, contact the patient and get
  the answers as soon as possible to avoid delay.
  Informing patient about out-of-pocket expenses
  can increase the opportunity to collect patient
  responsibility amount at the time of appoint
  itself.
• Medisys Data Solutions has been offering
  Insurance Eligibility Verification services to
  its clients. This service offered as a part of
  complete revenue cycle management. If you are
  looking only for Insurance Eligibility
  Verification service then you can connect with
  our medical billing manager. You can expect
  increase in cash flow, increase in error free
  claims, and ultimately patient satisfaction.

Medical Billing Services in Oregon