Our comprehensive eligibility check includes a review of patient insurance coverage, benefits, and limitations, giving you the information you need to make informed decisions about patient care.
By verifying a patient’s insurance coverage, benefits, and eligibility, healthcare providers can ensure timely and accurate payments, improve revenue cycle management, and provide a better patient experience.With the complexity of insurance policies and regulations, healthcare providers face challenges in navigating the verification process, which can lead to billing errors and unsatisfied patients.
The insurance eligibility verification process in healthcare typically involves the following steps:
➢Collect patient information: The healthcare provider will collect the patient’s demographic and insurance information, including their name, date of birth, insurance policy number, and group number.
➢Verify patient identity: The healthcare provider will verify the patient’s identity by checking their photo ID, insurance card, and other relevant documents.
➢Contact the insurance provider: The healthcare provider will contact the patient’s insurance provider to verify their insurance coverage and benefits. This could be done through telephone, mail, or using a web portal.
➢Provide patient information: The healthcare provider will provide the patient’s information, including their name, policy number, and date of birth to the insurance provider.
➢Verify eligibility & benefits: The insurance provider will verify the patient’s eligibility for medical services, including the services covered under their plan, deductibles, co-payments, and out-of-pocket limits & provider status. Any specific CPTs as per the SOP.
Why Do Health Insurers Require Prior Authorization?
The healthcare provider is usually responsible for initiating prior authorization by submitting a request form to a patient’s insurance provider. Insurance companies and health plans use prior authorization to make sure that a specific medical service is necessary and being provided cost-effectively.
The idea is to ensure that health care is cost-effective, safe, necessary, and appropriate for each patient. In the process of prior authorization, your insurer will make sure that certain criteria are met.
At ParaMed, we understand the importance of accurate and timely insurance verification in the revenue cycle management process. That’s why we offer top-notch eligibility verification services to help streamline your practice’s operations and improve cash flow.
Don’t let insurance verification be a headache for your practice. Trust ParaMed Billing Solutions to offer the finest insurance eligibility verification solutions.
To learn more about our Eligibility And Prior Authorisation Services, please reach out via email at info@paramedbilling.com or by calling 501-588-7969.
