Patient Eligibility Verification
Helping providers in submitting clean claims
Our Pre-Authorization and Eligibility Verification Services Are All You’ll Ever Need!
Patient Eligibility Verification is considered to be an initial step in the revenue cycle management that enables medical practices to see whether a patient is eligible for the treatment. It includes the breakdown of benefits and checking whether the healthcare service is covered by the patient’s insurance or not, along with other benefit options such as copays, deductibles, and co-insurance as well.
Verification of Eligibility is highly crucial to a medical practice overall. According to reports, approximately 70-75% of claim denials occur primarily due to errors or mistakes in the eligibility verification of patients by healthcare providers. This shows us that most practices are still not paying due attention to their eligibility verification processes, and paying its price in the form of claim delays and denials. Nevertheless, we at MPD are providing medical practices with a solution. Our Eligibility Verification services for physicians and private practices are devised to provide you with leverage in the medical billing domain.
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Eligibility Verification is More Important Than You Might Think!
Many physicians and private practices think of eligibility verification as a formality that is mostly overshadowed compared to the other steps in the revenue cycle management system. This is why the highest rates of claim denials are caused due to mistakes in a patient’s eligibility verification. To further add insult to injury, the claim denials are mostly non-appealable and irreversible because they fall in the category of hard denials. As a result, medical practices have to bear monetary costs along with a highly negative impact on the healthcare practice’s overall reputation as well.
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Why Outsource Eligibility Verification Services
As mentioned earlier, the first and foremost phase of the medical billing process is eligibility verification. A practice can only receive timely payments if insurance verification is done correctly. As a medical practice, you need to verify the patient’s eligibility before rendering any service. In case you fail to address the eligibility verification problem at the earliest, you are going to face delayed payments and even denials. As a result, it leads to lesser revenues and greater claim denials. This is where our Eligibility Verification services come in handy as you can easily hand over the job to our experts and focus on patient care for the best results
Benefits Of Outsourcing Eligibility Verification Service
Here are some of the major benefits of outsourcing eligibility verification with MPD.
Claim Denials Avoided
By outsourcing pre-authorization and eligibility verification, you can easily focus on the bottom line and avoid errors in the system leading to claim denials.
Low Operational Costs
We realize that in-house verification can be highly costly and therefore, our services are highly affordable and provide you with cost-effective alternative.
Easy to Scale Business
Our eligibility verification services for private practices are such that they provide physicians with critical leverage for them to scale their practice to the next level.
Improve Patient Care
Introducing efficiency into the initial phase of the revenue cycle management, we enable practices to focus on patient care, leading to patient satisfaction.
Our Eligibility Verification Experts Are Just A Call Away!
Our experienced eligibility verification consultants provide superior eligibility verification services to help you avoid claim denials. We handle end-to-end insurance verification in which we keep an eye on the coverage and benefits from the insurance providers to eradicate any chance of error or mistake. As a result, our claim submissions are highly accurate, leading to increased medical practice and patient satisfaction.
A Medical Billing Service You Can Trust!
At MPD, we tend to follow a complete and comprehensive process for eligibility verification of patients in order to accelerate your overall accounts receivable cycle. Our experts confirm the eligibility of a patient through the proper breakdown of benefits while obtaining required prior authorization before the patient visits the doctor’s or the physician’s office.
Our verification process consists of the following steps:
- The first step includes receiving patient schedules from the clinic, hospital, or any medical provider’s office.
- The second step involves entering the patient’s demographic information.
- The third step entails a breakdown of benefits with both the primary (on date of service) and secondary payers (co-pays or coinsurances, etc.)
- Our team then initiates prior authorization requests and obtains approval for the prescribed treatment.
- Lastly, we upgrade the revenue cycle system of the medical practice with the details obtained from the payers.
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Eligibility Verification FAQs
Why is eligibility verification necessary for medical practices?
Medical practices have to make sure that the healthcare services they’re offering are actually covered by the patient’s insurance. This is why they have to perform eligibility verification for the purpose.
What is meant by a Breakdown of Benefits?
The term Breakdown of Benefits (BOB) is used to represent the act of checking for co-pays, deductibles, coinsurances (%), or other non-covered amounts that are to be paid to medical practice or physicians by patients.
Why outsource eligibility verification to MPD?
MPD is a professional RCM Billing company that ensures proper eligibility verification and breakdown of benefits for medical practices to avoid any chance of claim denials affecting a practice’s overall revenue.
How much time is needed for insurance verification?
The usual time required for verification of benefits takes 20 minutes. However, it is recommended that you get in contact with the payer 72 hours before the appointment of the patient.
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