- Establish a Verification Method: Implement proactive protocols to optimize claim acceptance and minimize denials.
- Conduct Eligibility Verification at the Right Time: Implement proactive protocols to optimize claim acceptance and minimize denials.
- Save Information: Implement proactive protocols to optimize claim acceptance and minimize denials.
- Calculate Estimates for Patients: Implement proactive protocols to optimize claim acceptance and minimize denials.
Staying on top of the changing insurance landscape is an essential part of managing your healthcare revenue cycle. Through eligibility verification,thorough verification improves claim quality and ensure that patients understand their financial responsibility before they incur costs and keep cash flow consistent by collecting payments at the time of service. Preparing your patients for their appointment prior to arriving is a simple but highly effective way of avoiding common eligibility issues. To make this process even smoother, here are 6 top tips on how to properly verify patient eligibility.
Establish a Verification Method
Establishing a verification method is the first step when conducting eligibility verification. Although the traditional practice is to call or fax patient information to an insurance provider, that can be time-consuming. When outsourcing your verification method, our team will run the eligibility tests for you with the use of advanced billing software that can streamline eligibility checks saving you time.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Conduct Eligibility Verification at the Right Time
Although a verification method has been established, your staff will have to follow up with patients. One of the best times for your staff to conduct this verification is when patients are scheduling an appointment. Another perfect time to verify is at the time of check-in to ensure there have been no changes in the insurance plan since the scheduling of the appointment.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Save Information
Keeping track of the information collected and understanding payer rules for eligibility checks can save you time. Should there be a dispute between you and the patient’s provider, you will have proper documentation of eligibility verification. When outsourcing your eligibility and benefits verification, make sure the vendor is also saving patient information.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Calculate Estimates for Patients
Being able to offer an estimate of payment for your patients reduces the risk of the patient being caught off guard when collecting payment. We recommend you offer this estimate while on the phone scheduling an appointment with a patient. If you outsource this process, your vendor will be able to provide an estimate for you, saving you and your staff time.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Verify Payment Responsibility at Check-In
Although your staff may have verified the responsibility of payment while scheduling an appointment, it is important for them to verify this responsibility at check-in. This reduces the risk of patients being caught off guard when told they have a balance at the end of the visit.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Reassure the Patient
Lastly, it is important to reassure your patient that the eligibility verification process is to benefit them. They will feel better knowing that the information they provide you helps them receive the best benefits from their insurance provider. It also benefits you because it will save you time. Keeping up with patient eligibility and benefits verification is a must for both your practice's success - as well as the satisfaction of your patients. Taking proactive steps to pre-verify information can save precious time at check-in and out while guaranteeing that everyone receives the best rate possible.
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
Partner with Shoreline: Expert Billing & Coding Solutions
Shoreline Best Practice: Maintain rigorous documentation standards and conduct regular workflow audits to preserve maximum reimbursement.
