The insurance verification software used by healthcare facilities can minimize denied claims, and increase employee efficiency. This article will focus on the various types of insurance eligibility verification and which value they bring to healthcare providers.
Real-time eligibility verification systems allow staff to check a patient’s active health plan coverage and benefits instantly at the time of service. This software integrates with hundreds of payers and uses the patient’s information to submit electronic 270/271 eligibility and benefit inquiry transactions.
Key benefits include:
Real-time systems check patient eligibility with the payer as soon as the patient information is entered. Within seconds, staff can verify SNF insurance eligibility, effective coverage dates, co-pays, deductibles, and more. This eliminates long wait times on the phone and accelerates check-in and registration.’
Some vendors allow automated tracking of coverage changes, meaning you can continuously monitor patient data while they are admitted to the facility without extra effort and be aware of any changes that may later result in incorrect claims.
Top verification tools easily integrate with EHR, PM, and other practice software. As a result, employees can see the latest patient insurance coverage information in their database. Many vendors also offer single sign-on for quick access.
The software replaces a process that is otherwise done manually, decreasing the administrative expenses involved with eligibility checks and increasing staff efficiency.
Real-time checks are essential not only in the registration of patients but also in pre-authorization and referrals.
Batch eligibility verification allows staff to check insurance coverage data for a number of patients at once. This type of check can be performed at any other desired interval.
The method has a few particular benefits:
Such checks eliminate the need to verify coverage for each patient individually, which is more time-consuming. It enables the staff to save time and focus on other important tasks.
Batch software maintains records of all eligibility checks conducted. Thus, it is easier for the staff to identify which patients have been verified and which ones still need to be processed.
Progressive batch verification solutions directly integrate within EHR systems for improved workflow.
Eligibility APIs use advanced API (Application Programming Interface) technology to integrate patient insurance verification functionality directly into healthcare IT systems and software.
Benefits include:
Patient information is secured and shared only with healthcare IT systems. The only interaction between providers and payers is eligibility information requests and responses.
Eligibility APIs are quite flexible and can be integrated into various healthcare applications, web portals, and many others.
Due to the availability of various eligibility verification features, it is important to identify the options that will be most effective for your healthcare facility. Here are some key considerations:
Insurance verification is the first critical step of the patient revenue cycle. Intelligent software that can check patient coverage in real-time or in batches and ensures accurate data for claim submission.
Investing in strong verification systems boosts efficiency and care quality by quickly confirming coverage. Facilities should evaluate their current admissions and billing procedures to select the most suitable eligibility software, be it cloud-hosted, or API-integrated.
