It is surprising to note that most patients lack knowledge of their health insurance plan and coverage. Therefore, it is up to the medical practice to verify and make it clear of what is covered and what is not before the patient visit so that they are reimbursed fully and on time. Studies indicate that most of the medical claims are either delayed or denied due to incorrect or inadequate patient coverage provided at the time of visit or failure to update current coverage information by the medical practice staff. All of this can negatively impact the revenue stream and financial performance of your medical practice.
Well, what could be done? It is best to assign this crucial task to a professional insurance verification service provider who can minimize the chances of claims denials and maximize timely reimbursements. As the medical practice’s reimbursement rate depends on the quality of the insurance verification services it is important to make sure that you never go wrong with the choice of the provider. In this blog we have discussed some of the tips to consider when choosing a partner to work with.
First and foremost of all it is important to determine whether the insurance verification service provider strictly follows HIPPA protocols. As HIPAA sets the standards for protection of sensitive patient data, failing to adhere to it will put you in deep waters. In the event of HIPAA non-compliance you will be subject to legal consequences like penalties and fines. To avoid such situations, they should have all data security policies in place to ensure utmost confidentiality of patient’s insurance information. As HIPAA updates its rules and regulations on a regular basis, it is important that your outsourcing partner keeps up with the changing regulations in order to stay fully compliant.
Covers a wide range of medical specialties
Ensure that the insurance eligibility service provider you choose provides eligibility checks for a wide range of specialties. If they have the expertise working with various specialties, they will be aware of what to look for when evaluating each one for insurance eligibility requirements. As each medical specialty has their own set of regulations and requirements, it is imperative that the insurance eligibility service provider is well-versed with the types of services these specialties entail. The range of specialties they deal with is a fool-proof sign of how thorough and detailed their insurance verification services will be.
Knowledgeable about all private insurance carriers, Medicare & Medicaid
It is important that your insurance eligibility partner is knowledgeable about the different types of health plans and their coverage – from private insurance carriers to government-run programs like Medicare and Medicaid. Medicaid provides health insurance coverage for low-income families while Medicare is for elderly people. If your partner has an experienced team of insurance specialists they will know what to watch out for when processing insurance verification requests, thus reducing claim denials to a great extent.
Strict quality control and quality assurance process
When you choose to outsource your insurance eligibility services ensure that there is a rigorous quality check process at every level. A stringent quality check helps to evaluate for errors and inconsistencies before submissions. This ensures that denials due to inaccurate or missed information are under control. Regular audits also help to identify error patterns and ensure they do not occur. This not only ensures compliance with quality standards but also greatly helps to streamline the insurance verification process. For the purpose of quality management every team should be provided with a daily or weekly quality report. This report should be evaluated to track the types and number of errors. When reviewed on a regular basis it can help reduce errors and improve accuracy. Periodic performance evaluations of staff help to ensure better quality control measures.
Cost-effective yet quality services
Make sure that your outsourcing partner provides high-quality services at cost-effective rates that help you to save on your operating costs. However, while looking for affordable insurance eligibility verification services never compromise on the quality of service. This means you should never sacrifice quality while intending to cut down on your costs. Pricing should definitely take a back seat because outsourcing itself will ensure huge savings on overhead costs, irrespective of whichever provider you choose to go with.
Access to latest tools, technology and infrastructure
Ensure that your outsourcing partner has a skilled team adept in using high-end tools and technologies to ensure high levels of accuracy. And also they should be equipped with state-of-the-art infrastructure to ensure top notch and reliable eligibility verification services. In short, access to sophisticated tools and advanced technology eliminates the chances of errors and claim denials.
No initial set-up and training charges
Make sure that the outsourcing company provides end-to-end insurance eligibility verification services. This means that there should be no additional costs which may include set-up or training fees. If the insurance eligibility process involves setting up cost or training charges then it is a clear sign that you aren’t getting a good deal. Double check that there are no hidden charges included and make it clear that you will not be paying anything outside of what was agreed upon initially.
Partnering with the right insurance verification provider speeds up approvals, simplifies your workflow, increases clean claim rates, reduces rework on claims, boosts revenue and above all ensures a significant savings of 30% to 40% on operational costs. Well, are you thinking of outsourcing your insurance eligibility verification tasks to a reputed and reliable provider? If yes, Scribe4Me is your best choice. With a team of certified insurance verification specialists at their disposal you need not worry about claim denials anymore. Yes, now you can finally zero down on claims denied due to insurance eligibility errors and get to earn every dollar you rightly deserve. Scribe4Me experts check for any policy changes and health plan updates as well as take care of the entire paperwork that goes with verifying a patient’s coverage. Most importantly, by taking on the workload of insurance verification they help you focus on your core activity – patient care. Want to know more? Get in touch with Scribe4Me, today.
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