25 Oct The Electronic Benefit Verification Myth: Verify Insurance Eligibility with the Click of a Button
There is no shortage of companies offering “automated” eligibility/benefit verification services. They promise you can bid farewell to waiting on long phone calls to determine a patient’s benefits and get it done with a single click.
Not so fast. Welcome to Real Life. There are only a few ways to get some or all of the accurate information you need:
- Through your practice management system or other third-party software
- Using the carrier website
- Picking up the phone yourself
- Contracting with a professional revenue cycle management (RCM) resource to handle verification and eligibility
Shouldn’t practice management software do verification & eligibility?
Your practice management system is absolutely necessary to run your practice properly, but without complete and accurate information, it can’t formulate appropriate treatment plans for patients or meaningful revenue projections for you.
The perils of magical thinking
What about the magic button that gets and sends information?
Automated systems do not update the coverage tables in the provider’s software. They do not always provide accurate information on stipulations with certain procedures and waiting periods.
What other methods could be used to verify insurance benefits? Insurance carrier websites?
Sure, a lot of large payers have websites with information for verifying patient eligibility and benefits, and allow providers to enter information directly into their portal.
Here’s the but:
- They also each require their own set of logins, passwords, and specific procedures to allow entry
- The information available is unique to each insurance carrier, further complicating the ability to get consistent information for plan creation
- The information still has to be entered into the patient record
Your staff has to spend time going to the website, entering the data into your practice management system, and (probably) having to call the insurance carrier to get missing data.
What potential issues arise when automatic verification is incorrect?
The same as in manual verification. A simple error can result in claim rejections, payment delays and denials.
The Real Life Answers
Put your insurance eligibility and benefit verification on the professional level where it belongs with an RCM outsourcing company.
But again, don’t look for a magic push-button solution. An RCM company has to have both the technology and a knowledgeable, available staff (not an 800 number or a chat bot) to partner with you. And by partner, we mean Medusind.
Technology + People. It Takes Both.
Medusind’s proprietary QuickVerifyTM technology, along with a large staff of highly experienced and knowledgeable RCM professionals, will ensure that your verifications are done on time, every time, and with an unparalleled high level of accuracy.
We work with the largest DSO’s and the smallest practices, performing approximately 50,000 verifications every day. We align with each client’s protocols and assign dedicated teams to each one. In addition to eligibility and verification, we also provide a full range of services to meet all Revenue Cycle Management needs.
To determine how we can best serve you, a 15-minute conversation is a good place to start.
Call us at 949-240-8895 or email dental@medusind.com and we’ll set up a time.
It will be time well spent.
