Patient eligibility verification is the method of verifying whether or not a patient is qualified for insurance coverage and the scope of that coverage. It includes confirmation of the patient’s insurance overdetermination of the extent of coverage, co-payment, eligibility check, coinsurance, deductible, and other matters that may affect the payment for the delivered health care services.
Our eligibility verification service at MAVA Care tries to explain to healthcare providers the patient’s financial obligation and ensures they are compensated adequately for the services. By establishing a patient’s eligibility, we want to prevent claim denials, eliminate billing mistakes, and enhance the entire revenue cycle efficiency.
The insurance eligibility verification services mean that our healthcare professionals correctly determine a patient’s insurance status and their service fee. This information is important to generate correct bills and avoid billing issues, which can lead to claim denial or late payment.
Our eligibility check helps in detecting any potential issues that might contribute to a claim rejection. Such elements include addressing issues with the patient’s insurance policy, such as policy expiration or treatments that are not included in the plan, to reduce the possibility of claims being denied.
We inform healthcare providers by determining eligibility about their financial obligations, such as co-payments, deductibles, and other charges that may be payable. Transparency also reduces incidences where the patients feel locked in as they receive their medical bills because of the mathematical understanding of their obligations.
This is the last part of the revenue cycle that may be required for medical insurance eligibility verification. To ensure that treating a patient with active insurance, we ensure healthcare providers about the patient’s eligibility. These reduce the chances of providing services to uninsured or underinsured patients, thus enhancing the profitability of the organization.
First and foremost, we get the patient’s information, consisting of, but not limited to, the full name, date of birth,or their residence, and the insurance company they are covered under, along with the name and number of their insurance card. We then make copies of the patient’s insurance card, front, and back, to validate if all the information is right. Then go on to enter the patient’s information into the Electronic Health Record, Practice Management, or Real-Time Eligibility application, making sure all of the insurance information provided is correct and accurately entered into the system.
Further, we look up, electronically, whether the concerned patient is covered by his insurance, including the benefit in choosing the right kind of insurance and the type of services that will be covered. Verifying insurance eligibility involves confirming a patient’s coverage details and benefits with their insurance provider to ensure services are covered.
Our team of professionals has extensive training and expertise in negotiating the complexity of insurance plans, coverage, and benefits. We can swiftly and correctly review the patient’s eligibility check and benefits, minimizing mistakes and claim denials.
We employ cutting-edge technology to speed the verification process, which reduces administrative costs and increases productivity. Our technology enables us to speed up the verification process, saving time and money for your medical practice.
Your medical practice can save money by outsourcing eligibility and benefit verification. By reducing the requirement for in-house verification staff, you may save money on labor and avoid purchasing expensive software and equipment.
Our eligibility and benefit verification in medical billing can assist in increasing cash flow by lowering the number of rejected and denied claims. By confirming patient insurance information upfront, we can lessen the possibility of underpaid claims and denials.
Our solution is adaptable to meet the needs of your increasing practice. As your practice grows, the verification process becomes more challenging and time-consuming. We can swiftly build up the verification operation without requiring more personnel or resources.
We obtain information about the insurance policy number, insurance company name, type of plan, co-payment, coinsurance, and deductible amounts during eligibility and benefits verification. This information is used to verify the eligibility of a patient to receive medical care, the extent of coverage available for such treatment, and, where necessary, patient liability.
With changes in insurance plans, the process of eligibility and benefits determination is becoming ever more complex. Healthcare professionals need to stay informed about newer laws and regulations. If such a detailed verification of eligibility and benefits process is not done appropriately, then it will cause denials, delays in payment, unhappy patients, and a negative impact on revenue.
