How can accurate eligibility verifications help in reducing denials?

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Monday November 19, 2012

Non-verification of insurance eligibility may lead to several problems - delayed payments, rework, increased errors and patient dissatisfaction.

Physicians can benefit immensely by implementing an accurate insurance verification process prior to starting the medical billing process.

Industry Facts
Improper verification of insurance can increase claim denials One in every five medical claims are processed inaccurately by health insurers Health insurance industry as a whole has about 80% accuracy rate for processing & paying claims 1% improved claims processing accuracy creates an estimated savings of $777.6 mn. in unnecessary administrative cost

Hence physicians need to make every effort to ensure accuracy especially during eligibility verification which is the beginning of the medical billing process to ensure reduction in denials

Why Insurance Eligibility Verification? --- It Improves the AR Cycle!

Standard procedure of checking insurance eligibility of the patient helps in:

Identifying patients who have - changed carriers, have pre-existing exclusions & so on
Improves patient relations as your patients will be prepared in advance
Immediately increases your cash flow by collecting patient portions at time of service
Helps in sorting any disputes later with the insurance company regarding eligibility verification

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Setting up an accurate eligibility verification process at your practice!

Following a proper process for eligibility verification can help in reducing denials
Yet physicians limited by time restraints may need to team up with a good service provider

Outsourcing Health Insurance Verification = Reduced Rejections & Denials!

Advantages acquired by outsourcing eligibility verifications to MBC…

Improve cash flow	Reduce costs (30 - 40% below operational)	Increase efficiency	Increase upfront collections
Reduce claim denials	Reduce lost revenue in collections	Increase staff productivity	Increase patient satisfaction
Increase number of clean claims	Assistance in providing improved patient care	Reduce the time spent following up on claims	Increase office efficiency
Quick approval	Workflow simplified	Chances of risk reduced	Quicker billing cycles

MBC for over a decade now has been providing Insurance Verification – offered both as a separate component as well as integral part of our Medical Billing Revenue Cycle Management.


Outsourcing health insurance verification to MBC	=	Reduced rejections & denials + Improved patient care