First off, let’s define what patient eligibility is.
Patient eligibility verifies a patient’s coverage and benefits before receiving treatment, cutting back on claim denials so your practice’s cash flow isn’t disrupted.
Why Your Practice Should Consider Automated Patient Eligibility
Automating this process in your patient onboarding and checkup process makes communicating with patients about their financial situation easier – it’s much less complicated to talk about finances before the bill hits. However, there are other benefits specifically to your business to consider:
Reduced Insurance Issues
The back and forth between practices and insurance providers can often be time intensive. It becomes even more complicated if there are discrepancies in coverage patients assume they have. By automating checks before your patients receive treatment, it also reduces potential insurance claim issues.
Accurate Billing
Deductibles, co-pays, maximum benefits, coverage… all of these vary across patients. If a patient leaves their employer, or an employer changes insurance providers, patients may not understand the extent of their coverage themselves! Verifying these details ahead of time ensures you’re billing insurance companies correctly.
Patient Experience
Removing confusion about what treatment options fall under insurance coverage makes it easier for patients to understand their options. Beyond that, it also outlines what they’ll need to pay before the bill arrives in their mailbox.
Streamlined Billing Process
Understanding patient eligibility leads to a smoother billing process, speeds up claim submission and ultimately leads to quicker payment collection.
Clear Limitations
By understanding what each patient’s insurance permits, it’s easier to manage expectations with the patient while avoiding disputes about who’s paying for their treatment.
Regulatory Compliance
Verifying your patient’s insurance eligibility is one of many ways your practice adheres to healthcare regulations and billing guidelines.
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