Is your practice still manually verifying patients’ insurance?
This process can be incredibly time-consuming and costly for every patient you handle. According to a study in Journal of the Colorado Dental Association, it was found that staff spends about 12 minutes manually checking a single patient’s insurance. If your practice sees 40 patients a day, this adds up to 8.6 hours spent on insurance eligibility verification daily.
This report clearly indicates that one of your staff members must dedicate an entire workday solely to checking insurance. Switching to medical insurance eligibility software helps your practices streamline this process, saving both time and money.
What is Medical Insurance Eligibility Verification?
Medical insurance eligibility verification is checking the patient’s insurance coverage and ensuring that the medications or procedures your patients take are included in the coverage. Staff need to check the patient’s coverage is active without exceeding the annual or lifetime limits.
Your staff needs patient information for the verification of insurance coverage. It includes,
- Demographic information such as patient’s name, date of birth (DOB), address, etc.
- Patient’s insurance carrier information including insurance company’s name, policy number, and the patient’s insurance ID
- Patient’s insurance plan details by contacting the insurance company
How Medical Insurance Eligibility Verification Process Works?
The medical insurance eligibility verification process starts with the collection of patient identification details like name, number, address, insurance details like policy number, coverage details, etc.
In a traditional method, the next step involves manually entering the collected patient data into an eligibility verification system or submitting it through an insurance provider’s portal. The system then cross-verifies the patient’s insurance details against the provider’s database to confirm coverage, co-pays, deductibles, and other benefits.
Once the patient eligibility verification is completed, the system retrieves the information and displays it on the verification system – patient coverage details, benefits, and any out-of-pocket costs. Staff then tell patients the details of insurance, expenses involved, and any pre-authorization required.
Did you know? 🤔
According to one report, Healthcare fraud costs the industry up to $300 billion annually, driving up costs and increasing malpractice claims rates—making fraud prevention crucial for protecting both providers and patients.
What Makes Medical Insurance Eligibility Software so Crucial for Practices?
Medical insurance verification software automates the process of checking your patient’s insurance. This software collects data from multiple sources to check the prescribed treatment and medications covered by the patient’s insurance plan. In recent years, many practices have adopted verification software to drive operational efficiency and optimize revenue cycle management.
CERTIFY Health offers practices an industry leading automated medical insurance verification capability to reduce administrative workload and claim fraud. With our platform, instantly verify your patients’ insurance and check their current coverage benefits.
Benefits of Using Medical Insurance Eligibility Verification Software
1. Reduced Risk of Bad Debt
In the healthcare industry, errors in insurance claims are frequent and expensive. However,real time insurance eligibility verification software empowers your staff to accurately retrieve patients’ insurance information with a single click. This software pulls data from multiple sources to provide you with accurate and reliable coverage information.
By utilizing this technology, your staff can significantly reduce billing errors and avoid disputes with insurance companies. Practices can ensure they only bill for services covered by the patient’s insurance, and provide information on non-covered procedures, leading to a more efficient billing process and more educated patients.
2. Improved Patient Experience
Billing errors and delays can affect your patients, causing unnecessary stress. A common complaint among patients is the mismatch between the actual costs and estimated costs. Some patients struggle to settle their outstanding bills, when practices fail to provide clarity about amounts due.
Automated insurance eligibility checks help patients to plan for their financial obligations. Patients experience greater satisfaction with their overall payment process, while practices benefit from fewer payment delays.
3. Enhance Operational Efficiency
As we discussed earlier, your staff spends a significant amount of time in manual patient eligibility verification, creating unnecessary burdens and reducing overall efficiency. Managing multiple tasks—such as patient communication, insurance verification, and billing—only adds to the challenge.
A medical insurance eligibility verification software streamlines the verification process through automation. For practices with limited staff and high patient volumes, this software is invaluable. It reduces workload, enables real-time verification with minimal manual effort, and allows your team to focus on what truly matters—delivering high-quality patient care.
4. Compliance Adherence
5. Increased Revenue
The cost of eligibility errors extends beyond the revenue lost through claim denials. If practice’s fail to check insurance information practices need to bear:
- The burden of financial and productivity loss
- Delayed patient payments
- Reputational Damage
Medical insurance eligibility verification software can detect concealed mistakes, guaranteeing that claims and communications are accurate from the start. By reducing denials and identifying missing coverage, this software maximizes reimbursement and improves the patient payment process.
Did You Know? 🤔
Insurance claim denials have jumped to 16% in recent years, making it harder for healthcare providers to get paid on time. That’s where medical insurance verification software comes in—it helps reduce denials, speed up approvals, and improve insurance reimbursement rates.
Why does that matter? Because a higher reimbursement rate means faster payments, less administrative hassle, and better financial health for your practice. Instead of chasing down claims, you can focus on what really matters—delivering great patient care.
Features to Look for When Considering Medical Insurance Eligibility Software
- Instantly confirm your patient eligibility with real-time updates, avoiding reimbursement issues.
- With a user-friendly interface, insurance eligibility verification standardizes responses from multiple payers, allowing registrars to access patient details in a consistent format.
- Utilize detailed reporting and analytics to gain performance insights and help staff identify improvement opportunities.
- Ensure the tool integrates with electronic health records to verify your patient information quickly.
Automated Insurance Verification: A Smart Investment?
The best insurance verification software like CERTIFY Health’s insurance verification software is a smart investment for your practice, as it reduces your billing errors and claim denials leading to improved cash flow. It streamlines administrative processes and enhances patient satisfaction by providing accurate and timely eligibility information. Ultimately, it allows practices to focus more on patient care rather than administrative tasks and boost your revenue cycle management.
