The best time to perform eligibility checking is as early in the workflow as possible, generally when the patient's appointment is made. If the patient’s insurance status can be determined at this early stage of the process, potential problems can be handled well before the patient arrives for their visit. In the ideal situation, the center’s Practice Management System or EMR has incorporated eligibility checking directly into the system. In such cases, adding an appointment can automatically trigger a check. The response can be read immediately. However, even with a standalone eligibility checker, it only takes a moment to enter a few fields and then obtain a response a few seconds later.
Another easy time to add this function to your workflow is when the patient arrives for their appointment. With Practice Management System integration, the insurance status is obtained and displayed automatically at the reception desk when the patient checks in and is logged into the system. And again, even without such integration, simply taking a moment to enter a few fields into your standalone eligibility checker and then reviewing the response another moment later is easily performed. In both cases any issues that arise can be addressed immediately with the patient standing right there.
Benefits of Insurance Eligibility Verification
If the insurance is active, the response will display the current status of any deductibles as well as any co-pays. If any problems are identified, for example, the insurance system having an incorrect birthdate, they can be corrected immediately. And if it is determined that the patient does not have active insurance, then payment options can be discussed BEFORE the patient has the procedure.
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