Details to Check during Insurance Eligibility Verification Process Details to Check during Insurance Eligibility Verification Process

 The process of insurance eligibility verification is not as simple as cross-checking data.  There are hundreds of insurance providers in United States alone—and they all update their plans frequently.  Unchecked details lead to insurance claim denials.  Unfortunately, many details fall into the cracks because hospitals, clinics, and other healthcare organizations often lack the manpower to focus on this task.

 The best solution is to partner with an offshore medical billing company to prevent rejected claims.  By partnering with an offshore medical billing company, your billing company or physician group saves time, energy, and money.  Offshore medical billing companies in India are affordable, and since they are doing all of the medical billing, you gain more time to focus on your Client Service or patients based on your business.

 However, choosing the right business partner is essential in the offshore space! E-care has over 16 years of experience.  We offer end to end medical billing services, from insurance eligibility and benefit verification, Demo Entry, Coding, Charge Entry, Transmission, Payment Posting,  Accounts Receivable and denial management, patient registration, indexing medical records, and much more.

 We are ISO-certified, a member of the HBMA or the Healthcare Business Management Association, and comply with the regulations and the latest HIPAA rules.  When we go through the process of insurance eligibility verification, we receive the schedules of the patients via , fax, or EDI.  We make sure to verify the Insurance for patients two days or more prior to the encounter depending on the requirement from our client.  We have highly skilled and experienced team who is capable of maintaining the TAT and accuracy over 98%!

 Our team may also regularly check the schedule through the appointment and scheduling software.  The next step is to verify the patient’s insurance coverage with the insurance company.  This involves making calls to the insurance providers, speaking with the insurance representatives or requesting fax through IVR and checking information through their authorized insurance portals online.  If need be, we contact the patients for more information.

 Post which, the team updates the billing system with the details of eligibility and benefits verified, such as the co-pay, coverage period and identification (member ID, group ID, etc.)  The team also input other information such as deductibles and other benefits information including maximum limitations.  In the event that there are issues arising from a patient’s insurance eligibility, the client is informed as soon as possible.  This streamlined process will considerably reduce rejected and delayed claims and increase practice collections.  It also shortens your revenue cycle.