eligibility verification

3 Ways to Make Your Eligibility Verification Process More Efficient

Eligibility verification is the first step in the revenue cycle – and arguably, the most important. Without an efficient verification process, it’s hard to communicate with payers and determine payer/patient payment responsibilities. These challenges can increase the number of mistakes made during claims submissions. They may also add time to your average A/R days or lower the revenue you’re able to capture each month.

If you’re familiar with the costs of patient eligibility challenges, try a different verification approach. Here are three ways you can increase eligibility verification efficiency.

1. Take advantage of real-time eligibility verification opportunities

Verifying patient eligibility via individual payer portals or over the phone is not ideal. These processes are extremely time-consuming. They delay patient access to treatment and often cause stress for front-of-house staff.

A real-time verification process, available through a single eligibility portal, is much more efficient. It simplifies communication with payers and provides quick eligibility answers, meaning your team can verify coverage in a matter of seconds, not hours or days.

With the right tool, you can enjoy this fast, highly efficient workflow to communicate with Medicare, Medicaid and private payers.

2. Save time with saved patient data  

Real-time verification is just one of the many workflow benefits that an eligibility portal like ABILITY COMPLETE® can provide. Additional functions may include storage of eligibility transaction history and the ability to resend prior eligibility requests.

Having access to this data offers significant time-saving opportunities. It gives your team all the information they need to quickly verify patient eligibility every single time a patient comes in. This replaces the slow, tedious task of asking patients to fill out forms and having staff manually input their information. It results in increased patient satisfaction and decreases the likelihood of sending claims with inaccurate information.

3. Educate patients and collect payments before treatment

To achieve a high level of efficiency throughout the revenue cycle, engage patients early on. Educate them about their coverage and their payment responsibilities. Break down the costs of treatment for both long-term and one-time services, and collect each payment at the time of service.

Providing patients with an understanding of their payment responsibilities up front helps your business avoid possible loss of payments. It reduces the risk of inadequate benefit challenges after treatment has started, and it increases the likelihood that a patient completes their long-term care plan.

Innovative processes combined with attentive patient care can transform your RCM performance. In terms of eligibility verification alone, the best way to improve efficiency is to focus on working faster while producing more accurate results.

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