3 – 5% of lost revenue is due to medical bills errors such as insufficient documentation and inaccurate coding. Verification of patients’ insurance details and how payments will be processed is an imperative front office role. This is because failure to do so may result in huge margin losses. Real-time eligibility verification has provided a turnaround in such situations, among other medical technology complications. It provides sophisticated solutions essential for saving time, optimizing processes, and boosting revenue.
Real-time eligibility verification is error-free, cost-effective, and works faster than most contemporary solutions. Its deployment has facilitated seamless payments for both the provider and the payer. Read on to discover more about real-time eligibility verification and its benefits in the management of a healthcare organization.
What is Real-Time Eligibility Verification?
Real-time eligibility allows providers to verify patient insurance information in real time. Whereas previously, office administrators relied on a phone call or fax to verify information such as a patient’s coverage status, copay, etc., they can now verify that information virtually, and almost instantly. As you can imagine, this has spared many office staff from grueling check-in process hurdles and long phone calls with insurance companies.
By using real-time eligibility, organizations have been able to decrease the collections lost from check-in mishaps, and increase the efficiency of the check-in process, improving the revenue cycle, patient experience, and employee satisfaction.
The information available through real-time eligibility includes but is not limited to:
- Coverage dates
- Type of coverage
- Claims mailing address
- Patient demographics
- Lifetime maximum
- Total and remaining deductible amounts
- Benefit options
- Referrals and pre-authorizations
Benefits of Real-Time Eligibility Verification
Boosting Employee Satisfaction
These tools streamline a lot of the processes that demanded a substantial amount of time from the front office staff. Phone calls to insurance companies while managing a restless front office can be daunting. By utilizing real-time eligibility, front office workers are empowered with the ability to access necessary information without relying on an insurance rep.
Verifications can be conducted anytime, such as during appointments and patient registration. This helps identify any uncollected revenue from the patient as you get instant responses after the verification. Also, note that pre-check services help update and access insurance and payment information. Such real-time eligibility practices improve income generation and minimize losses. It also speeds up registration and other processes that help to increase claim payouts.
Boosting Patient Satisfaction
Real-time eligibility improves patient satisfaction by creating more organized processes. By utilizing this tool, patients’ perceptions of your organization’s competency and resourcefulness improve, standing to improve your organization’s reputation. It ensures appointments are executed as planned and patients don’t have to wait in long queues before seeing a doctor.
Reducing Number of Denied Claims
Denied claims are a burden to any healthcare organization’s revenue cycle. Real-time verification ensures that all data is accurate and recorded accordingly in the system with no human error. This ensures that your staff can access the exact information from the systems every time claims arise and solve the denied claims with no worries.
Real-Time Eligibility Verification for Your Facility
Eligibility verification has proven a notable entity in managing everyday workflow practices and patient experiences. It helps you get essential deductible information and co-payments within a short time.
Working with a clearinghouse that offers real-time eligibility, like Apex EDI, can save your office time, and money. Apex EDI has a 95% claim acceptance rate and a comprehensive range of features such as claim status reporting, OneTouch claims processing, practice management integration, and more. Contact us today to request a demo and enjoy the benefits of real-time eligibility with Apex EDI.