The Importance of Eligibility Verification
For many providers, the ability to verify a patient’s eligibility prior to submitting a claim has been out of their reach. However, patient eligibility verification is a crucial part of any practice’s process to reduce claim rejections and denials of patient insurance coverage and co-payments up-front.
Ineligible patient insurance coverage is the leading cause of claim rejections and denials by payers. It is necessary for chiropractors to determine the flexibility of patient coverage, which includes co-pays, deductibles, inpatient days used, pertinent benefit data, and payment arrangements. Ideally, this should all be known prior to rendering services so you are assured that you will get paid.
Having a system for eligibility is necessary for all chiropractic practices. Below are the 6 benefits:
Shortens the patient check-in process
Services like CTProClear provides access to benefit information from thousands of insurance companies/plans in seconds. Rather than getting back to your patients’ days later, having the information readily available saves you and your patients’ time.
Increases point-of-service (POS) collections
It’s beneficial to know co-payment and deductible information upfront. And in ideal situations, your practice should have the ability to collect payments in multiple ways such as credit card, ACH, and cash payments, at the same time of the inquiry.
Saves staffing costs and time
Practices that do not have a clearinghouse takes up a lot of time from staff. The staff spends a lot of time calling, faxing and searching for benefits information from individual payers. Proprietary service code mapping yields richer and more accurate eligibility responses. All responses arrive in a single easy-to-read format regardless of payer—that can be easily saved, archived, and searched.
Helps minimize rejections
Systems like CTProClear checks whether any information submitted in the inquiry differs from what’s in the payer’s system, then automatically corrects it.
Improves efficiency by obtaining eligibility within the staff’s workflow
It’s vital for the application program interface (API) to provide eligibility integration within your practice management or health information system, such as ChiroTouch. With an integrated clearinghouse like CTProClear, staff can simply press a button to immediately confirm patient eligibility, eliminating waiting game, saving you, your staff, and patients time.
Provides same or similar verification for DME providers
Systems can help determine whether the patient is eligible for reimbursement by Medicare. In this instance, the patient will know at the time of service, avoiding unnecessary documentation or additional steps if it was handled after. This can minimize errors compared to manual input by staff members, which will also help reduce bad debt from HSA and high-deductible plans.
A good system for eligibility verification will help optimize your finances. Now it is within reach for ChiroTouch customers with CTProClear. CTProClear in integrated within the ChiroTouch system that’s the most convenient solution. If you’d like to learn more, click here and our CTProClear specialists will be happy to go over the many benefits with you.
ChiroTouch provides this information with the understanding that authors or speakers are not experts in finance, regulatory policy or law. ChiroTouch shares this information to the best of our knowledge and experience. The information is subject to change as the COVID-19 crisis evolves.