How to Improve the Patient Eligibility Verification Process?

Patient eligibility verification is one of the first steps in the medical billing process that needs to be done right to get paid on time. Patient eligibility verification involves identifying and verifying patients’ coverage details, copayments, deductibles, and more. Healthcare practices must keep up with the latest trends and technologies to verify patient eligibility and deliver the best medical care to their patients. There could be several factors for an insurance claim can be denied. But, taking a few proactive measures can help avoid claim rejections and improve your overall billing process, leading to increased cash flow.

This blog presents you with the most effective ways to incorporate to improve the patient eligibility verification process in medical billing.

Starting in Advance is Beneficial

Update the patient’s current health insurance information before scheduling an appointment for treatment. This allows to simplify the patient eligibility verification process and leads to proper utilization of time, which can be useful to fill in the information gaps that might potentially result in claim denial otherwise.

Review Patient Information During Pre-registration

It is always better to re-check and review the patient coverage details when the appointment is near. This step is important to fill in any missing information or rectify any incorrect information that was documented at the time of appointment scheduling.

Use Technology-based Platform

Technology plays an essential role in streamlining the complexities of the patient eligibility verification process. Adopting technology-based platforms to automate the eligibility verification process can enhance efficiency and accuracy, preventing claim denials.

Educate Patients About Financial Responsibility

It is very essential to remind patients about their financial responsibility at check-in. When patients call to schedule their appointments, remind them about their responsibilities. This helps patients to be clear about the payment expectations at the time of service or treatment.

Switch to Real-time Verification

Eliminate the manual verification procedures and replace them with real-time verification through a single eligibility portal to avoid claim denials and payment delays. Real-time verification will help you enhance your practice workflow. Also, ease up the process of coordinating and communicating with the payers.

Identify Pre-authorization Needs

Check the health plan’s policy and rules for a particular patient to see if prior authorization is required for a treatment or service. If required, submit a prior-authorization request to obtain approval. This will ensure timely care and reduce the claim denial risk.

Verify With The Insurance Provider

Patient eligibility verification is incomplete without verifying the details with the insurance provider. This is a crucial step in the patient’s eligibility verification process. So, cross-check every patient coverage detail with the insurance providers before proceeding further to ensure everything goes smoothly.

Monitor The Reasons For Eligibility-related Denials

Tracking the patterns of patient eligibility-related denials and understanding the reasons for denials can help take proactive steps to resolve them on time to improve the patient eligibility verification process and prevent future claim denials.

Outsource To Professionals

Outsourcing is an effective way to improve the patient eligibility verification process at your healthcare practice. Professionals who are high-experienced bring their skill sets and talent to optimize medical billing and improve accuracy in the patient eligibility verification process. Therefore, outsourcing your patient eligibility verification needs to experts can improve your overall financial performance.

Capline Healthcare Management offers an efficient and cost-effective real-time patient eligibility verification that helps mitigate all errors and mistakes in the whole medical billing process. Our EV experts ensure that the patient eligibility verification process is correctly executed well in advance of the patient appointment. This enables healthcare practices to save time and resources that they may have to invest while managing the eligibility verification process on their own.