How Outsourcing Patient Insurance Eligibility Verification Reduces Denials

‘Nip in the Bud’ — this proverb applies to everything and the healthcare industry is not an exception. Medical billing claim denials have increased in recent times due to new medical reforms, regulations & standards, and technology & software upgrades. Errors don’t just occur in medical billing functions alone. There is a possibility for such errors to occur very early in the process, which is insurance eligibility verification. As soon as a patient comes into a hospital, the first step that happens is the patient registration. During this stage and verification process, many mistakes can happen. Therefore, nipping these mistakes in the bud would be wise. It will help reduce denials at a later stage considerably. Partnering with offshore vendors is a great solution. Let’s learn their process of handling insurance eligibility verification to reduce claim denials:

· Thorough Document Check: The first and the foremost step that a reputed offshore billing company does as and when it receives patients’ schedules via EDI, email, or fax are doing a thorough check on the appointment scheduling software. By analyzing and verifying them, the vendor will be able to easily organize documents as per the insurance company’s standards and expectations. Also, it can avoid errors if any.

· Insurance Coverage Verification: This is one of the important steps in the insurance eligibility verification process. Letting the patients know whether the medical services will be covered by their primary or secondary Payers is crucial. Surprising them with a huge medical bill at the end of the service is not a good practice. It will affect the patient-doctor relationship badly. A good offshore vendor checks this information by either calling the Payer or using the authorized online insurance portals.

· Stay in touch with Patients: Maintaining a good relationship with patients is one of the best practices. If there is any missing information or documents, an experienced offshore billing company will immediately contact the patient and request them. Ignoring them will contribute to a huge claim denial rate at a later stage.

· Update the Insurance Eligibility Verification Software Constantly:Sometimes patients move to a new location and the address changes. It has to update in the system. Not just this information, a good offshore vendor will check details like member ID, group ID, co-pay, deductible, and coverage period multiple times and update them into their system to ensure error-free medical billing and coding.

· Submission: The final step in the insurance eligibility verification is submitting the documents to clients. The documents have all the necessary patient details including, insurance coverage start & end dates, coinsurance, eligibility, and benefits.

Advantages: By performing exceptional patient insurance eligibility verification, medical billing companies can avoid huge claim denials. However, handling all the medical billing functions in the present scenario can be challenging. Therefore, partnering with a reputed offshore vendor will take off some of the burdens from their shoulders.

About e-care India:

If you are searching for a good offshore medical billing company, then look no further than e-care India. This company offers exceptional medical billing services and also provide a dedicated team to take care of the insurance eligibility verification process accurately. The Disaster Recovery Centre in e-care will make sure that your business continues even during emergency times. It helps in minimizing delays and reducing write-offs to improve cash flow. To know more about e-care and its services, log on to www.ecareindia.com.