How To Make Your Insurance Eligibility Verification Process More Efficient?

Insurance Eligibility Verification

Insurance eligibility verification is the initial and most significant step in the revenue cycle management process Without the eligibility verification process, it’s difficult to communicate with payers and determine the payer responsibilities. These difficulties can increase the number of errors during the claims submissions and also increase the average A/R days & lowers the business revenue. Let us discuss how to process insurance eligibility verification more efficiently.

Insurance Eligibility Verification 

Insurance eligibility verification is the process of checking the patient’s insurance coverage status, eligibility status, etc. Here listed Below is the checklist of information to be verified for a smooth and productive billing of each claim. Type of Medicare coverage

  • Coverage dates
  • Patient demographics
  • Benefit options – including patient responsibilities for co-pay, co-insurance & deductibles
  • Individual plan deductible and deductible remaining
  • Family plan deductible and deductible remaining
  • Referrals and pre-authorizations
  • Claims mailing address
  • Lifetime maximum
  • Address for claims submission
  • In-network or out-of-network status
  • Durable medical equipment coverage

Without verifying this information, healthcare services may be wrecked. Eligibility verification is of paramount importance as any deficiency may lead to claim denials and account receivables delays etc. The major reason for claims denials and delays is that insurance eligibility verification is not done accurately.

Optimize Insurance Eligibility Verification Process

Here are some of the  techniques that can be followed to make the insurance verification process work effortlessly:

Check the patient’s insurance coverage with the payers by reaching the administrators through calls, Interactive Voice Response (IVR), and portals. 

Updating e patient data accurately is essential. Our medical billing team gathers the patient details and gets the eligibility verification, claims details, etc. If any issues found during the eligibility verification process, the issue ought to be set out to avoid denials. Through the eligibility verification process, any miss in the patient data or the claims get updated and claims submitted error-free.

Outsourcing Makes Your Practice More Efficient

Outsourcing free up the workforce to focus on progressively productive tasks, and meanwhile improve payment and collections. The redistributed firm that you will work together with will focus on accelerating approval and co-ordinate with the insurance company concerning pending claims. Outsourcing engages you to have better control of your business. It will make your practice effective and ensure smooth working with staff and smoothed out a business process. 

About e-care India

e-care India is the top medical billing outsourcing company in India. We specialize in Insurance eligibility verification. Our company has necessary security certifications including the SSAE 18, which is an added advantage. We have a Disaster Recovery Centre to make sure that business continues even during emergency times. To know more about e-care and its services, log on to  www.ecareindia.com.

What is Medical Billing and Coding?

Medical Billing and Coding

Medical Billing and Coding is the backbone of US Healthcare and has become the need of the hour for many physicians and hospitals. The process of Medical Billing begins right from patient registration with a Doctor’s office and continues till the servicing provider receives all due reimbursements from the insurance company which is the primary requirement for any physician and healthcare. However, their primary focus on Patient care can take their attention from prioritizing Medical Billing affecting your financial bottom line.   Additionally, the challenges and complexities involved in streamlining the medical billing process and getting them done with maximum payments for the physician mandate the role of Medical billing companies!

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Leading And Most Common Dental Billing Errors

Dental Billing has its own challenges and any lags in Dental billing can affect the claim reimbursement. However being accurate and billing only for the exact services rendered is also primary requirement as otherwise these errors may invite unwanted legal issues to the practice, physicians, patients or all parties involved. Dental billing rules and regulations have now become more concrete and upholding high standards of integrity to avoid fraudulent billing is crucial. Listed below are few illegal or fraudulent billing errors mostly prevalent across the industry which needs to be curbed to protect the physicians and billing practices.

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Types of Process in Accounts Receivables in Medical Billing

In medical billing, accounts receivable refers to the outstanding payments owed to a healthcare provider for services rendered to patients. Managing accounts receivable is crucial for the financial health of medical practices. There are several types of accounts receivable in medical billing, each representing different stages of payment processing. Here are some common types:

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Understand Current Trends, common billing mistakes, and 6 critical things to know about Ambulatory Surgical Center Billing

Ambulatory Surgical Center Billing

Outsourcing Billing services for Ambulatory Surgical Center (ASC) simplifies the complexities and challenges involved and results in higher ROI. Offshore Outsourcing can qualify US-based Medical billing companies for greater benefits and profitability. Ambulatory Surgical Center have more specifications and specialty-based nuances in charting out the claim and processing them with the insurance payor; which makes it cumbersome and laborious to be handled In-house. Let us try to understand the complexities involved in billing for ASC to know why Outsourcing has become the latest trend in ASC specifically.

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The Impact of Medical Record Indexing on Patient Data Management

Medical record indexing plays a crucial role in patient data management, significantly impacting various aspects of patient care, medical billing and coding process and the end result of claims processing and collections. Medical Records Indexing helps retrieve relevant reports as and when required, such accessibility positively impacts patient data management: Below listed are few key impacts of Medical Records Indexing on Patient Data Management:

Efficient Retrieval of Patient Information

Indexing involves categorizing and organizing medical records based on relevant criteria such as patient demographics, medical conditions, treatments, and dates. This indexing allows healthcare professionals to quickly locate and retrieve specific patient information when needed, enhancing the efficiency of care delivery. It reduces the time spent searching for data and enables faster access to critical information for making informed decisions.

Improved Patient Safety

Accurate indexing of medical records helps enhance patient safety by ensuring that healthcare providers have access to complete and up-to-date patient information. By organizing records systematically, indexing reduces the risk of missing or incomplete data, minimizing the potential for errors in diagnosis, treatment, or medication administration, medical billing and claims processing. This can lead to better patient outcomes and reduced medical errors.

Enhanced Continuity of Care

Indexing facilitates seamless continuity of care by enabling healthcare professionals to track and access patient information across different care settings and encounters. Whether it is a primary care physician, specialist, or hospital staff, having indexed medical records ensures that the relevant patient data is available, allowing healthcare providers to make informed decisions and provide appropriate treatment based on a comprehensive understanding of the patient’s medical history.

Support for Research and Analysis

Indexing plays a vital role in research and analysis of patient data. By properly categorizing and indexing medical records, researchers can efficiently retrieve specific patient cohorts for studies and analyze data to identify trends, patterns, and outcomes. This data can be used to drive evidence-based practices, improve healthcare protocols, and advance medical research.

Streamlined Billing and Coding

Accurate indexing of medical records assists in efficient billing and coding processes. Properly indexed records enable billing staff to identify and assign appropriate codes for procedures, diagnoses, and treatments, streamlining the billing process and reducing the chances of errors or omissions. This contributes to accurate reimbursement, improved revenue cycle management, and reduced administrative burdens.

Compliance with Regulatory Requirements

Effective medical record indexing supports compliance with various regulatory requirements and standards, such as HIPAA (Health Insurance Portability and Accountability Act) in the United States. Compliance includes maintaining privacy and security of patient information, ensuring data integrity, and enabling auditability. Proper indexing helps manage and organize records in a manner that aligns with these regulations, facilitating data protection and privacy.

In summary, medical record indexing significantly impacts patient data management by enabling efficient retrieval of information, enhancing patient safety, supporting continuity of care, facilitating research and analysis, streamlining billing and coding processes, and ensuring compliance with regulatory requirements. It contributes to improved healthcare delivery, patient outcomes, and overall operational efficiency in healthcare organizations.

About Ecare

e-care – one of the leading Medical Billing based in India has over 23 years of experience in end to end Revenue Cycle Management Outsourcing Services and offers additional value added services such as Indexing Medical records, Physician Enrollment and Credentialing and Insurance Eligibility Verification services with guarantees results. To know more about Ecare and our services call 1-813-666-0028 or log on to Medical Record Indexing | Electronic Medical Record Scanning | e-care India (ecareindia.com)