Eligibility verification is an extremely important procedure done by healthcare providers prior to rendering the service to a certain patient. Providers need to get patients’ eligibility details in order to find out if the service they are about to perform is covered by an insurance plan. A properly checked eligibility is key to successful claim payment and an absence of claim denials. Not only does it let providers know if they are going to get paid, but also how much, and if they should collect any patient responsibility, such as copays, deductibles, and coinsurances. As a result, if eligibility is checked correctly, providers face no unreasonable underpayments, and patients are protected from a surprise bill. To discover the strategies of proper eligibility verification, continue reading!
Eligibility Verification: Most Neglected Process of your revenue cycle management (RCM)