Insurance Eligibility
Insurance Eligibility
Efficient Insurance Eligibility Verification, Clean Submission
Insurance eligibility verification is critical to ensuring accurate and timely receipt of information regarding insurance coverage. It helps to determine the responsibility that the patient and the insurance provider have to share to pay for healthcare services.
Verifying Insurance Eligibility involves:
Accurately recording personal information of the patient and their insurance coverage
Contacting Insurance Provider, confirming the policy, and obtaining Pre-authorization(s)
Following up with the patient, if needed, and updating the billing system
Verifying the insurance eligibility offers clinicians a clear view of the patient’s coverage that determines the type of treatment they can provide to the patient while minimizing the patient’s financial burden. Medical insurance should be always be verified before the clinical visit.
Lapse in Insurance Eligibility Verification can result in:
Delays with Patient Visit
Claim Denials and Rejections
Delayed Reimbursement
Why Verify Insurance Eligibility?
Studies indicate that claims worth millions are denied every year due to expired eligibility, or because the treatment service was not covered by a particular insurance plan. Verifying the eligibility of the patient allows the billing staff to analyze insurance coverage for clean claims and avoid re-submissions or rejection.
- Determine treatment service per the insurance coverage
- Avoid claim rejection and optimize claim submission
- Streamline revenue cycle management with increased reimbursements and maximizing cash flow
- Maintain up-to-date medical records for further documentation
- Identify patient’s responsibility before the clinical visit
- Enhance patient’s satisfaction
Studies indicate that claims worth millions are denied every year due to expired eligibility, or because the treatment service was not covered by a particular insurance plan. Verifying the eligibility of the patient allows the billing staff to analyze insurance coverage for clean claims and avoid re-submissions or rejection.
- Determine treatment service per the insurance coverage
- Avoid claim rejection and optimize claim submission
- Streamline revenue cycle management with increased reimbursements and maximizing cash flow
- Maintain up-to-date medical records for further documentation
- Identify patient’s responsibility before the clinical visit
- Enhance patient’s satisfaction
Studies indicate that claims worth millions are denied every year due to expired eligibility, or because the treatment service was not covered by a particular insurance plan. Verifying the eligibility of the patient allows the billing staff to analyze insurance coverage for clean claims and avoid re-submissions or rejection.
- Determine treatment service per the insurance coverage
- Avoid claim rejection and optimize claim submission
- Streamline revenue cycle management with increased reimbursements and maximizing cash flow
- Maintain up-to-date medical records for further documentation
- Identify patient’s responsibility before the clinical visit
- Enhance patient’s satisfaction
Why ScribeEMR
Streamline Insurance Processors & Reimbursements
ScribeEMR provides highly qualified staff to research relevant information regarding the insurance coverage of a patient. Insurance eligibility verification is done well in advance of the clinical visit. Eligibility is double-checked with the insurance provider, and discrepancies, if any, are conveyed to the patient and clinical team.
Streamline Insurance Processors & Reimbursements
ScribeEMR provides highly qualified staff to research relevant information regarding the insurance coverage of a patient. Insurance eligibility verification is done well in advance of the clinical visit. Eligibility is double-checked with the insurance provider, and discrepancies, if any, are conveyed to the patient and clinical team.
Streamline Insurance Processors & Reimbursements
ScribeEMR provides highly qualified staff to research relevant information regarding the insurance coverage of a patient. Insurance eligibility verification is done well in advance of the clinical visit. Eligibility is double-checked with the insurance provider, and discrepancies, if any, are conveyed to the patient and clinical team.
Improved A/R Cycle
With robust eligibility verification process offered by ScribeEMR, patient flow is streamlined and A/R is optimized.
Automated Eligibility Verification
Our professionals are able to assess automated eligibility verification using advanced RPA tools, thus streamlining processes.
Improved A/R Cycle
With robust eligibility verification process offered by ScribeEMR, patient flow is streamlined and A/R is optimized.
Automated Eligibility Verification
Our professionals are able to assess automated eligibility verification using advanced RPA tools, thus streamlining processes.
Least Rejection/Denial Rate
Well-trained experts gather every useful information by paying attention to the details, ensuring extraordinarily low rate of insurance denials
Establish Trusted Contact
Expert professionals of ScribeEMR work closely with patients and the insurance providers via the optimum channels to secure updated insurance information and obtain pre-authorization.
Least Rejection/Denial Rate
Well-trained experts gather every useful information by paying attention to the details, ensuring extraordinarily low rate of insurance denials
Establish Trusted Contact
Expert professionals of ScribeEMR work closely with patients and the insurance providers via the optimum channels to secure updated insurance information and obtain pre-authorization.
Efficient Workflow
Insurance eligibility verification is accomplished well before the clinical visit by obtaining information via patient scheduling systems, insurance web portals and telephonic discussion.
Maintain Comprehensive Records
Records of primary & secondary coverage are maintained, including member ID, group ID, coverage period, co-pay, deductible and co-insurance information, and benefit information
Efficient Workflow
Insurance eligibility verification is accomplished well before the clinical visit by obtaining information via patient scheduling systems, insurance web portals and telephonic discussion.
Maintain Comprehensive Records
Records of primary & secondary coverage are maintained, including member ID, group ID, coverage period, co-pay, deductible and co-insurance information, and benefit information
Utmost Adherence to Confidentiality
We respect and maintain the sanctity of patient-provider confidentiality. No information is ever given out to any third party without a patient’s written consent.
HIPAA Compliant
We comply with all HIPAA rules. Personal portable electronic devices are prohibited inside the working area that has limited access to the Internet. All coordinators attend HIPAA training through our Learning Management System.
Utmost Adherence to Confidentiality
We respect and maintain the sanctity of patient-provider confidentiality. No information is ever given out to any third party without a patient’s written consent.
HIPAA Compliant
We comply with all HIPAA rules. Personal portable electronic devices are prohibited inside the working area that has limited access to the Internet. All coordinators attend HIPAA training through our Learning Management System.