Best Practices for Eligibility and Benefits Verification

Importance of Eligibility and Benefits Verification

Claims denial can be challenging to manage for any healthcare provider who accept patients’ appointment from different insurance. Preventing claim denials can be time saver and collection improvement technique. It is also not worth the time and effort to see a patient multiple times, wait for the billing until the end of the month, and then file only to realize that these patients are not even eligible for behavioral health benefits. Eligibility verification particularly when done in advance solves this problem, allowing you to give significant information to your patients before their appointments.

Right Verification Method

Every practice has unique needs, resources, when it comes to eligibility verification. While more traditional practices like calling or faxing patient information to insurance providers might work for some smaller practices, other high-volume practices might find that tedious and time-consuming. Outsourcing can be one method like hiring a third-party to run eligibility tests for you, or purchasing verification automation software

Eligibility Verification Time

It’s also significant to make sure that your staff is verifying patient eligibility at the right time and to set a schedule for routine batch verifications. However your practice should find a schedule that is right for your staff and your needs, there are a number of occasions that are typically recommended for eligibility tests.

Data check

Data required in the eligibility verification process must be exact and real time. A serious review of the entire data concerning these two aspects is essential. Old data or incorrect data or missing data can prove detrimental to the process’s successful execution. When such data is presented to the insurance company it is either straight away rejected or held over for long periods resulting in financial loss and affecting the account receivables.

Take professional assistance

Verification process is best executed by the experts. You can use professionals to carry out this task for you and engage your staff in other areas that require more focus and attention. The subject matter experts can handle every stage of the insurance verification process with utmost clarity, confidence, and competence. With the experience of dealing with multiple clients, the professionals can identify the gaps better and find better solutions to resolve issues faster.