Importance of Patient Eligibility Verification in Preventing Claim Denials

patient eligibility verification

Do you want to improve the efficiency of your billing process and increase your rate of accepted claims? You’ll benefit from learning more about patient eligibility verification. As Florida’s expert in medical billing, PracticeForces can help you reduce the frequency of your medical billing denials and improve how quickly you receive reimbursement. Keep reading to learn everything you should know.


What Is Patient Eligibility Verification?

Patient insurance eligibility remains an important step in the medical billing process. It checks a patient’s insurance plan to verify their eligibility for benefits and coverage. It helps healthcare providers receive more efficient and consistent reimbursement to better manage their cash flow.

Without verifying a patient’s health insurance, you may file a claim for which they don’t qualify for coverage or may submit inaccurate information, leading to a denied claim.


3 Benefits of Eligibility Verification

Improving how you handle eligibility and benefits verifications has three main benefits.


1. More Accurate Billing

The most immediate benefit of improved verification involves it resulting in more accurate billing and claims filing. A leading cause of denied claims stems from inaccurate coding and filing a claim the patient’s insurance plans don’t cover. Improving your verification process ensures your billing specialists have all the details they need to file an accurate report.

2. Fewer Claim Denials

Because improved patient eligibility verification reduces inaccuracy in billing, you’ll also see a reduction in claim rejections due to lack of information or improper insurance coverage. At best, denied claims reduce the speed at which you receive reimbursement, but at worst, the company won’t let you refile, and you’ll miss out on your payment.

3. Increased Efficiency

Verifying insurance in advance helps you better allocate resources and schedule more efficiently while freeing staff to focus on interacting with patients and providing a higher level of care.


Improving Eligibility Verification Practices

Follow these tips for improving insurance claims acceptance rates using an improved verification process:

  • Improved data collection: Your front-desk staff should collect and check whether the patient has updated insurance or billing information before every appointment, and you should encourage patients to fill out all the required registration information before their appointment.
  • Increased automation: Utilizing an electronic health record system and office management software can decrease human error, improve data collection, and automate mundane tasks that let your staff focus on other areas.
  • Advanced verification: Collecting eligibility information before you schedule an appointment with patients helps them understand their financial obligation and make an informed decision about their treatment plan.
  • Established protocols: When you develop consistent procedures to handle verification, your team can perform the tasks more quickly and with fewer errors.


Contact the Medical Billing Experts

Now that you know the importance of patient eligibility verification, you can take steps to optimize how you handle the process. You don’t have to do it alone, and PracticeForces is a reliable partner in managing your practice. From helping you understand the top reasons for claim denials to handling all your medical billing needs, our team of experts can help. To receive a quote for our services, call (727) 202-5429.

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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