How Real-Time Insurance Eligibility Verification Maximizes Reimbursements
Healthcare technologies today aim to develop automated software solutions and frameworks to save time, optimize processes, and boost revenues.
Real-time eligibility verification software expedites payment processes for both the payee and the payer. This software will cross-check, verify, and update patient information. It automatically enhances RCM (Revenue Cycle Management) for healthcare providers. By saving time and resources to verify accurate patient data, it generates more economical operations for the healthcare organization. Otherwise, the operation can be slowed down due to manual efforts and/or data errors leading to claim rejections, denials or write-offs.
Rejections and denials heavily affect the revenue cycle management process for any healthcare provider. Many rejected/denied claims are even abandoned, contributing to even more significant revenue losses. Real-time eligibility verification software is vital for reducing rejections, denials and rework for healthcare providers It provides patient data needed to process clean claims including up-to-date insurance policies, deductibles and co-pay status, an estimate of out-of-pocket expenses, tentative billing amounts, etc.
Reasons to choose real-time insurance eligibility verification software-how can it maximize revenues?
Real-time eligibility insurance verification maximizes reimbursements by offering insurance providers immediate access to information necessary for submitting and paying claims. This data includes critical information such as levels of patient coverage, coverage dates, co-pay obligations, etc.
Verifies the patient and their coverage from the start: The information about a patient will be recorded right from when he obtained an appointment until the time he pays the bill to be discharged. Real-time verification tools will verify in terms of seconds, not days.
No need to call payers; the system automatically verifies: In previous years, companies would call to verify every piece of information. Real-time insurance eligibility software automatically verifies data, eliminating the chance of discrepancies or delayed claims. Moreover, you don’t have to keep calling the payers to get reimbursements, as the insurance companies are automatically updated when verification happens.
Prevents rejections/denials: Long-term healthcare providers must be cautious about denial claims. Providers know the patient’s coverage when admitted using real-time eligibility verification tools. In the past, verifications were stalled because of incorrect or incomplete patient information, expired coverage or services not covered by insurance. This verification may be done before admission as part of a scheduling procedure for some patients, which helps minimize risks of denied or rejected claims that are common when providers accept the patient’s word. Cutting-edge verification software imbibes machine learning and AI solutions to identify risks of claim denial even before these happen.
Reduces work: When you have top-of-the-line software to provide eligibility verification for patient information, the chances of mistakes are practically negligible. The number of denied claims is lessened because of accurate real-time results.
Faster submission process: Since the verification tool provides accurate and error-free information, claims can be submitted and processed faster. When the number of denied or rejected claims is lowered, there won’t be delays in receiving reimbursements from insurance providers.
Increased cash flow: Real-time eligibility verification solutions streamline a healthcare organization’s revenue stream, making it more efficient and consistent.
Now that you understand the benefits of using real-time insurance eligibility verification software, it’s time to make the change. Request a discussion today with a subject matter expert.