Why are practices Outsourcing Insurance Eligibility Verification?

Verification of patient insurance eligibility has become more important than ever. Most medical claims get denied or payment gets delayed due to inaccurate coverage details provided by patients during their visit. Claims also get denied when the administrative staff doesn’t update the coverage information. These mistakes impact the cash flow of the practice or hospital to a great extent, delaying payments.

Why are providers outsourcing this task?

From reducing denials and minimizing appeals to obtaining payments at the appropriate rates, there are several reasons why providers are choosing to outsource patient eligibility verification services.

They are realizing the need to have trained staff who can verify if the patient has coverage and if their insurance plan is covering the rendered services.

This is much needed because practices can face significant revenue loss if claims are denied due to no active coverage, out of network or unauthorised patient visits and procedures.

By hiring a team of trained medical billing and coding experts, they have been able to prevent delays and reduce denials of insurance claims.

Perks of outsourcing Eligibility Verification

Partnering with a reliable billing company gives you access to their expert staff who are updated with the changes in health plans and policies. Having worked for various clients, they understand the importance of eligibility verification in getting their clients paid on time.

Here are some of the services they provide:

  • They perform document checking in which they analyse all documents that they have received from the healthcare organisation or the insurance provider. They verify them agains the list of necessary documents in order to organise the papers as needed by the insurance companies
  • It is their job to verify patient insurance coverage with primary as well as secondary payers. They do this by either contacting the patients directly or by checking their official insurance portals online.
  • A reputed billing company also handles the task of patient follow-ups. If needed, they contact the patients promptly in order to seek inaccurate or missing information. Through this task, they get to keep a track of all the data and also get to cross verify the details before the final submission is done.
  • Their team handles the final submission, providing clients with final results that includes information about the patient’s eligibility and benefits. It also includes details such as member ID, group ID, copay information, start and end date of the insurance coverage and so on.

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