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.
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!
What clients say
Account Managers are always readily available to help me. I appreciate their efforts daily! Our AM is a true gem and gift to any client account she manages. Her knowledge and suggestions aid me and my clinic in many ways. I would never have been able to execute a few items without her help. I was not in my current role before they chose to use Billed Right, however, I do see reports that show substantial increases in Revenue for my company. I appreciate the transparency of reporting, coding, and claims with the team and within the system. I would highly recommend Billed Right to others. In fact, at the most recent Meditab conference, Billed Right’s contact information was given freely with praise to several small business owners in need of financial assistance.
Practice Administrator of Urgent Care, TN
Billed Right has depth that similar service organizations do not. There is not a one or two-person team that handles everything. It is an organization that as a team understands our account. We have senior leadership, on the ground leadership and day to day team members that know our account. That is not easy to replace and certainly, at our size, not something we could bring internally without a significant commitment to infrastructure. While we cannot speak to how they may align with a specific set of needs…they are a professional organization with solid tools. Ultimately you will choose an outside billing partner for the simple reason of increasing collections. This will happen with Billed Right…but to us…as much as increasing our cash flow is their team of professionals. I like them, respect the contribution they make to our company and openly offer my personal recommendation.
CEO, Pain Management, CA
I have been associated with Billed Right for the past two years since I started my practice. Billed Right have been incredibly helpful in assisting my practice with initial credentialing, providing prompt responses to all my requests and excellent service to address my concerns. I am very satisfied with their timely insurance billing, collections, low AR, and patient accounts management. My Account Manager meets with me regularly to review and discuss management reports and address my questions in a professional and promptly manner. I am very satisfied and could not ask for better service. For these reasons I highly recommend Billed Right to anyone looking for a reliable practice management service.
Psychiatry Provider, FL
Billed Right is very knowledgeable in every aspect of business. When our Dr. First acquired the practice, it was a huge mess because one provider was leaving, and one was coming in but Billed Right stuck in there with patience and loyalty. Account Managers are top notch when it comes to every aspect of the business and make sure that you are comfortable in what they teach you. Staff members are very competent and have patience of saints to put up with credentialing and enrollment processes. Staff are polite and know what they are doing and go out of their way to help in every situation. I want to thank each one of the teams. Patient call rep is awesome and is also top notch in the field.