Key Strategies to Improve the Patient Eligibility Verification Process

by | Last updated Jun 29, 2023 | Published on Jun 21, 2023 | Resources, Infographics | 0 comments

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As physicians focus on patient care, they also need to implement proper medical billing practices to ensure appropriate and timely reimbursement. Patient eligibility verification is a vital component of the billing process. It involves confirming patients’ coverage details, including information on coverage limits, copayments, deductibles, and more. Verifying patient coverage before delivering services can help prevent claim rejections related to eligibility issues, improve cash flow, and enhance the overall patient experience. By prioritizing eligibility verification, healthcare practices can achieve financial stability while providing high-quality patient care.

Patient eligibility verification process involves various steps such as – patient scheduling and enrollment (patient’ s demographic and insurance details are collected), eligibility verification (patient’ s active coverage is verified with the insurer), prior-authorization (obtaining approval from the insurance company for a medical procedure or service), informing the patient (patient is informed about the outcome of the verification process), and updating the medical billing system -(billing system is updated with insurance verification and eligibility details).

Outsourcing patient eligibility verification to experienced professionals can promote adherence to best practices. Established insurance verification companies have skilled teams well-versed in the intricacies of various insurance plans. They can ensure accurate and timely completion of the verification process well in advance of patient appointments and as required thereafter. Leveraging their services can save practices the time and resources that would be needed to manage the complex patient eligibility verification in house.

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Strategies to Improve the Patient Eligibility Verification Process

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