RCM SERVICES
Medical Billing Insurance Eligibility
One of the biggest pain areas of any medical practice is delayed or incomplete patient insurance eligibility. As a result, patients come in for visits without paying any of their upfront responsibility, copays, or deductibles, which leads to increasing Accounts Receivables (AR). Your staff simply cannot keep up with the front operation and complete all the insurance eligibility in time!
Not only can not completing eligibility result in uncollected upfront payment of copays or deductibles, but eligibility issues can also cause claim denials. Thus putting even more stress on the staff to have to go through the appeal process, or worse, bill the patient because the service wasn’t covered by their insurance plan. In a poll done by MGMA, it was noted that 15% of the participants stated that eligibility was the root cause of claim denials and another 5% stated out-of-network was. Twenty percent of their participants had medical claim denials that could have been prevented if the front office handled all the eligibility details before the patients were seen.
Denials also contribute to a large AR by slowing down payment of claims by three to six weeks, depending on how long it takes to appeal the denial. To make matters worse, there is a loss of approximately $100 per claim in staff time to handle each appeal. The costs just keep adding up!
Wouldn’t it be nice to have someone handle verifying all eligibility details including copays, deductibles, out-of-network, and if the service is covered by the patient’s insurance plan for you? Ensuring all of this information is ready and available when the patient checks in.
At Billed Right, verifying eligibility is the first step of our revenue cycle management service.
OUR EXPERTISE
How do we do it?
- Insurance verification and patient eligibility details are checked far ahead of the appointment to ensure 100% upfront collection and eligibility notification to patients.
- We verify copay, deductible, CPT coverage, OON coverage, and insert this information into your practice management system for easy access during the check-in process.
- Communication is set up with front desk staff via an instant messaging system to assist with any eligibility questions and any walk-in patients.
Setting your practice up for success is our goal, so making sure that the revenue cycle management process is done correctly from the very first step is a priority.
Contact us today to learn more about how we can help streamline your process and save you time and money!