Due to its exceptional and effective Medical Billing services, NEO MD has emerged at the top of the list of Medical Billing companies in Indiana. By raising the number of patients, which eventually increases incoming payments, our medical billing services assist doctors/providers in making their businesses more profitable. Our billing and coding services are flexible and may be used by urgent care centers, specialized practices, or general care clinics.
Patients now have more financial responsibility due to expanding consumerism. High deductible health plan (HDHPs) growth is a blatant sign of this development. Therefore, it’s crucial to establish coverage and explicitly understand the patient’s upfront payment commitments.
This article highlights the importance of benefits and patient eligibility verification.
What does “Patient Eligibility and Benefits Verification” mean?
A healthcare facility must verify the patient’s patient’s coverage for the medical treatment and confirm their insurance coverage. Physician practices can verify the coverage provided by the health plan and copayments, deductibles, and coinsurance with the health plan through the patient eligibility and benefits verification process.
Eligibility Verification lowers the possibility of refusing claims and encourages collecting coverage information. It makes it possible for healthcare providers to collect payments from clients proactively and avoids delays in cash realization.
Several important cities, like Indianapolis, Fort Wayne, Evansville, South Bend, and Gary, are reachable by our Indiana Medical Billing specialists. Our professionals can literally handle all of the specialties that make us one of the leading medical billing companies in Indiana.
Information Needed to Verify Patient Eligibility and Benefits
The upfront collection of patient information is a crucial part of front-office duties since it enables insurance verifiers to verify benefits. Medical Billing companies in Indiana obtained the following information while verifying the edibility and benefits of the patients.
Information Insurance Companies Need
- Subscriber name
- Patient name
- Patient’s relationship with the subscriber
- Patient date of birth
- Patient gender
- Patient member number
- Group name and number
- Plan type
- Coverage date (policy effective date
Insurance Verification Elements
- Deductibles
- Co-pays
- Co-insurances
- Payable benefits
- Patient policy status
- Effective date
- Type of plan and coverage details
- Plan exclusions
- Claims mailing address
- Referrals & pre-authorizations
- Life-time maximum, and more
Staff employees at healthcare facilities must get training on insurance verifications. Processing quickly speeds up the cash flow cycle and lowers the chance of denials.
Strategies For Manually and Electronically Verifying Eligibility
As the patient count witnesses a significant expansion in the healthcare practices, outsourced medical billing companies in Indiana focused on innovative approaches. The majority of payers have made online eligibility check interfaces accessible. Prior to the planned patient appointment, you can electronically confirm eligibility.
- Assess the patient’s insurance coverage with precision and comprehend the health plan’s advantages.
- Check to see if co-payments need to be taken during service.
- current insurance information
- Patients should update their primary care physician information.
It could be required to call the payer occasionally with inquiries about the prerequisites for prior authorization or to explain certain aspects of eligibility and benefits.
Timeliness Of Eligibility Verifications
At least 48 hours before the appointment, healthcare practitioners must verify eligibility. If this is not feasible, it can be done in real-time prior to the treatment upon checking in. Quick eligibility checks assist you in lowering claim denials and rejections. The majority of revenue cycle management and electronic health record systems feature electronic eligibility checking functionality. Your practice may lessen denials and increase revenue realization by checking the patient’s insurance before providing service.
Importance of process Documentation
Your practice has specific requirements. The eligibility verification standards for a hospital or radiology clinic differ substantially from those for a drug use support clinic. As a result, each institution needs to develop its own protocols for verifying benefits and eligibility. Your team members must work well together to complete each phase with efficiency.
The rules and regulations governing medical service reimbursement differ from state to state for private insurance and public payers. The NEO MD team is very experienced and stays up to date with these laws state-by-state. We, as a leading supplier of medical billing companies in Indiana, focusing on the specifics of billing, coding, compliance, and more to help you manage your business successfully. With Neo MD, you can concentrate more on your patients and worry less about Indiana medical practice revenue cycle management.
If you’re considering outsourcing your prior authorizations to revenue cycle management companies with qualified prior authorization specialists, we strongly encourage you to look into NEO MD insights.
Checklist for Verifying Eligibility
There are numerous medical billing companies in Indiana working with their schedule, but only a few can follow the CMS guidelines while verifying eligibility. NEO MD medical billing company is often well known for its maximum clients based in Indiana and enjoying its flexible medical billing services. Our revenue cycle management services exactly fit the practices regardless of their size and patient count.
The following are best practices for determining a patient’s eligibility and benefits:
- Verify the status of the plan.
- Always inquire about any upcoming or recent insurance changes with the patient.
- Verify whether the patient has primary, secondary, and tertiary insurance. A patient’s Coordination of Benefits (COB) should be updated with each payer
- Verify Medicare coverage for patients who are over 65 since a sizable portion of the population in the United States is aging.
- Recognize whether you require a referral or prior authorization for the particular medical procedure. Please get the necessary referrals or authorizations and update the revenue cycle system if necessary.
- Verify the patient’s insurance coverage for the procedure.
- A cap on benefit limitations and restrictions on the number of visits and time frames during which medical services can be provided may be included in some plans. The front desk must obtain these facts.
- Calling the insurance provider may be necessary for some services, such as those related to behavioral and mental health, drug misuse, and addiction. You must consult payer-specific guidelines if you are unaware of these criteria.
- Payments are the patient’s obligation. Depending on the specifics of the coverage, collect payments for deductibles, copayments, and coinsurance. It might be laborious to pursue patient collections, and you have to make the required upfront payments.
- Additional details: Social determinants of health are advancing healthcare fairness and access and are becoming a crucial component of care delivery. For Meaningful Use reporting, details like race, gender, ethnicity, birthdate, preferred language, etc., are crucial. Studies on health equity must also have these qualities. Additional information collection gives us an edge over other medical billing companies in Indiana; this may improve our denials rate.
How does NEO MD Works?
NEO MD claims to provide your Indiana practice with excellent billing services. We review the overall healthcare process, spot billing mistakes, submit accurate claims with precise codes and complete transparency, and get the most compensation for your services in the shortest amount of time. Modern medical billing also dramatically benefits from technological advancement. Online claim processing is done using our integrated system. Errors are found using an automated rule-based scrubber. You may view and reconcile the precise account condition depending on the situation. Insurance companies for patients may get automated reminders for appointments and payments. Additionally, we produce regular medical and financial reports to evaluate practice progress, making us the exclusive outsourced provider among other Medical Billing companies in Indiana.
What Makes NEO MD the Best Indiana Medical Billing Services Company?
NeoMD stood best among competitors Medical Billing companies in Indiana due to the following cores;
- Improve RCM system efficiency with a robust credentialing team.
- Our experts work hard to reduce your front-end denials by 20%.
- Refunds adjustment and Payment posting to improve the cash flow.
- Offer internal audits to uncover loopholes
- Increase the accuracy of fees and collection.
- Offer Services that are easily scalable at all times.
- Out of Network Negotiations.
- Provide fortnightly financial and practice overviews.
- Provide Medical Billing and collection services that are of high quality and error-free.
- Use the latest technology and tools.
- We have consistently increased the collection rate for our clients because of the faster processing of accounts receivable and on-time follow-up.
Let’s schedule an appointment and discuss it in-depth with Medical Billing and Coding specialists. Contact us now at ([email protected]) or (929) 502-3636).