Insurance Eligibility Verification: Cause of Losses Or a Profit-Builder

Insurance Eligibility Verification: Cause of Losses Or a Profit-Builder

Insurance Eligibility Verification

A full-service dental provider, open for more than 25 years, with 300+ offices nationally had developed serious collections issues because their Insurance Eligibility Verification process had become inefficient.

With their significant patient volume, and the number of dental insurances they accepted, the company’s staff-based insurance verification practices had become lax, creating a significant number of denied insurance claims. Denials included charges for services not covered by the individual’s plan, lapsed insurance, or procedures for which the insurance company had already paid the maximum allowed.

This was translating into untenable revenue loss.

Revenue-Driving Insurance Verification Needed: Call Medusind

At Medusind, Insurance Eligibility Verification is performed by a team of specialists who do only Insurance Verification. They’re experts in navigating the differing verification requirements of each of the major insurance payers. They know the contact personnel.

Because of their expertise and efficiency, the Medusind Verification team performs 55,000 – 60,000 verifications every day. The accuracy of their verifications generate consistently clean claims that increase revenue and positively impact the financial health of every practice they serve.

Medusind Means Measurable Results

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In the case of the full-service dental provider, thanks to the number of verifications performed by Medusind, versus verifications done by their in-office staff, the practices’ increase in collection rates exceeded 7.17% within the first SIX months working with Medusind.

Not only was the overall collection rate higher, the higher rate remained consistent, month-over-month.

With the burden of verifying eligibility and benefits removed from their work flow, this enterprise dental service organization (DSO) was able to achieve the revenue-building results they were seeking; and continue to maintain these results through their ongoing outsourcing partnership with Medusind.

The One-Site, One-Call Verification Myth

While it is possible to go directly to payer portals and sites, these frequently offer only outdated or inaccurate information. That results in the necessity of a phone call to the payer, which usually leads to getting put on hold. Sometimes for 20 minutes or more. And that lost time can add up across all the patients who have insurance.

There’s also no such thing as a “yes” or “no” eligibility confirmation. Staff has to know the deductible, co-pay, coinsurance, frequency limitations, covered services, plan minimums, and waiting periods of the patient’s plan.

Multiply all that by the number of plans an insurance company has, plus the number of the patients a practice is actively seeing, and it becomes clear why insurance verification so often doesn’t happen.

Medusind Into the Future

Size of practice or number of years of operation are no guarantees against the difficulties of Insurance Eligibility Verification. If verification problems are impacting revenue growth in your practice, or hampering scaling efforts, call Medusind.

Removing this time-consuming process from your workflow by putting it into the hands of our dedicated, experienced Insurance Eligibility Verification professionals can put your practice back on track to reach its growth targets.

See how Medusind can work for you

Tell us about your business or organization and we’ll connect you with a Medusind expert who can show you the products in depth, and answer any questions you have. See how a provider, office manager, or biller use Medusind to empower their practice.