An important part of the entire revenue cycle management is Insurance Eligibility Verification.
This is a vital step in the cycle which refers to the process of reviewing and checking a patient’s insurance plan’s coverage.
Eligibility verification is important in timely & correct payment posting, increasing the number of clean claims and reducing billing errors and denials.
Offshoring eligibility verification can help improve claim payment accuracy and maintain a low backlog of work by properly identifying pricing and/or submission inconsistencies to management.
Aside from reviewing a patient’s insurance plan’s coverage and status, eligibility verification includes regular updating and monitoring of the patient’s basic information and electronic medical records, contacting of the payor, and identifying co-pays and deductibles.
Eligibility verification specialists contact insurance providers to verify if a patient’s insurance coverage is eligible and active. They verify that the data entered from the claim form is accurate and complete to enable the claim to be processed correctly by insurance payers. They make follow-up telephone calls to maintain accurate records and ensure that medical record account entries are up to date.
Verifying insurance eligibility ensure timely payments, avoid billing errors, and non-payment or eligibility denials.
Accurate data entry is provided by outsourced eligibility verification specialists. They provide effective and accurate patient record transcription, verify data entered from the claim form is accurate and complete to enable the claim to be processed correctly and accurately.
