Insurance Verifications – New Way to Improve the Check-In Process & Bottom Line

Healthcare workers who are at the front desk and in the billing office are at the epicenter of an unprecedented “shake-up” in health insurance coverage and physician reimbursement. These employees struggle to keep pace with this rapidly shifting healthcare landscape. They experience the day-to-day challenges brought on by each new development.  This is especially true when it comes to accurately collecting insurance and billing information from patients.  At DataFile, we are constantly working to improve existing technology, find creative staffing solutions, and ultimately develop service lines that will serve your patient, your employees and your practice.

Automated insurance verification is a feature of most electronic health record systems, but many practices still experience technology gaps and other challenges with their current verification solution.  As practices strive to prioritize patient satisfaction, staff efficiency and profit, those efforts call for a creative approach.  Providers need a solution that will complement what is often already in place, solve existing gaps and accomplish their objectives in such a way that makes financial sense.

Needs Often Outpace Growth of Front Office & Billing Staff

Determining the current active insurance for patients is not always easy.  New health plans regularly emerge and existing plans consolidate, deductible and copay amounts change frequently and coverage sometimes alternates from active to inactive monthly.  Insurance verification software is already widely adopted, but unfortunately, challenges still remain.

In nearly all physician offices employees fulfill multiple roles, making it difficult to become an expert in any one area. Whether it is due to difficulty assimilating health plan web-portal changes, or the challenges of understanding the intricacies of third-party verification tools, simply finding the time to perform proper insurance verification can be difficult.  In addition to the straightforward tasks, more time is needed to research any possible discrepancies.  Without the right insurance verification tools and expertise, medical offices risk overburdened staff members, incomplete coverage information, annoyed patients and decreased cash flow.

Patients Want Guidance on Insurance Benefits

Despite confusion brought on by regulations and consolidation, patients want to understand their insurance coverage and benefits more than ever. If patients have questions, they expect your staff to have the answers. Ultimately, your patient satisfaction can be impacted because patients believe medical offices have a responsibility to “get it right” when it comes to knowing coverage details, collecting copays correctly and submitting accurate insurance claims the first time.  When a seemingly straightforward task, like insurance verification, is not done correctly, a simple trip to the doctor’s office can turn into a frustrating journey for the patient.

The patient’s first impression of your practice often starts with insurance and benefits verification.  Getting this wrong for a patient greatly effects overall patient satisfaction for that visit, and ultimately impacts your practice’s reputation.  When a comprehensive insurance verification process is in place, patient experience is improved by:

  • Creating a smooth check-in experience
  • Decreasing patient wait time up to 70%
  • Ensuring correct financial responsibility is communicated at the time of service
  • Preventing the patient from receiving unexpected future bills
  • Establishing an atmosphere of trust of confidence in the healthcare provider

Although there are certainly layers of complexity when attempting to achieve high levels of patient satisfaction, knowing the correct insurance coverage information is a great start and one the practice can easily address.

How the Practice Benefits

Along with improving your patient experience, accurate insurance verification offers substantial benefits to the practice. Whether it is due to billing the wrong payer, collecting an inaccurate copay or simply tackling claim rejections, practices have many negative effects when insurance verification fails. Improving quality and speed for insurance verifications has a significant impact on the bottom line by:

  • Increased cash flow
  • Improved efficiency with front office and billing processes
  • More accurate point of service collections
  • Fewer write-offs due to incorrect payers, uncollectible amounts or untimely filing

While no solution for verification will have 100% accuracy, our insurance and benefits verification solutions combine advanced technology with staffing expertise, creating a measurable impact on the financial health of the practice.

Physician / Clinician Benefits

The overall practice benefits and those felt by the patient are fairly obvious, but clinicians also benefit from utilizing a purpose-built insurance verification solution. In fact, decreased check-in time creates a more efficient back office, allowing more patients to be seen.  Additionally, knowing up front the coverage in effect for the patient keeps last minute cancellations to a minimum and helps the provider’s schedule stay full.

Why DataFile for Insurance Verifications?

With DataFile’s insurance eligibility verification (IEV) solution, practices can leverage experienced HIM specialists blended with purpose-built technology to maximize revenue and maintain consistent patient volume. Through a secure connection, our team will seamlessly access your patient schedule, perform insurance verification, and when needed, search for and report all insurance coverage currently in effect for the patient.  Performing this function optimally prior the patient’s appointment fosters more efficient workflow, alleviates some burden for staff members and allows staff to stay focused on patient-centered functions. Put simply, the right IEV solution can increase patient satisfaction and the engagement of healthcare workers involved.

A Solution Tailored to Your Needs

Because insurance eligibility influences your practice from top to bottom, we understand your need for an insurance verification service that can be structured to suit your unique needs and does not interrupt current workflow. We offer multiple service options including basic verification, coverage discovery, customized patient benefit summaries and even a patient cost estimation tool. Ultimately, we want to help you overcome whatever your challenges are and hope you choose to discover how insurance verification can present a great opportunity instead of being a constant burden. Learn more about insurance eligibility by contacting us today.

1 reply
  1. Deb Pearl
    Deb Pearl says:

    This article was very interesting. I have been curious about different types of businesses and have just been doing some research. Thanks for the great and informative read!

    Reply

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