If there is something that doctors and healthcare professionals cannot quite manage, it is going through detailed documentation. They have important tasks at hand, providing life saving care to patients, ensuring their wellbeing, and guarding the reputation of the healthcare practice they are involved in. But there are certain non-core tasks that need to be performed which do have a bearing on the earnings of the practice. Insurance eligibility verification and insurance claim submissions are two of these tasks that need to be performed with utmost precision.
It is always important for a physician or healthcare practice to properly understand health insurer contracts before signing up or preparing a claim to submit. They should have a clear understanding of how their insurer contract will affect the expenses and revenue of their practice.
Understanding Insurance Contract Terms Well
Being unaware about the insurance claim submission requirements, payment policies and appeals process of the health insurance provider can affect the claims submission process and make it incorrect. This is where most troubles arise, mostly because the practice staff is not fully aware of the terms and conditions of the insurance deal.
Things that healthcare providers need to watch out for are factors such as the reimbursement they are likely to get under the particular insurance contract, the possibility of the health insurer changing the reimbursement terms, the existence of any kind of obligation for the insurer to promptly pay the healthcare provider, the definition in the contract of care that is “medically necessary,” and so on.
An insurance verification company can really ensure that all these things are taken care of perfectly. This is why hospitals, nursing homes, emergency care centers, rehabilitation centers and individual physician practices need to outsource insurance eligibility verification.
Getting the Hang of Minute Details
There are many minute details involved here which are hard for physicians to take note of. They really need to hire trained and experienced professionals exclusively for insurance verification. This may be quite resource consuming which is why healthcare practices would do better to outsource these responsibilities. This is where a medical billing and coding company, that also offers insurance eligibility verification, comes in.
It can handle all non-core responsibilities related insurance eligibility verification and claims submission, and help ensure prompt payments, streamlined functioning and greater sustainability for the healthcare practice.
Julie Clements, OSI’s Vice President of Operations, brings a diverse background in healthcare staffing and a robust six-year tenure as the Director of Sales and Marketing at a prestigious 4-star resort.