Virtual Assistance service can save minimum two hours per day of your front desk staffs work time, which can be used for other fundamental patient assistance. Virtual help is made to retain the diverse difficulties looked by the client's front office staffs on day today premise. Patient scheduling, patient insurance eligibility and benefits verification, keeping up with patient arrangements and addressing patient's inquiries on bills and installments and documentations are the fronts wherein our customer solution team assumes control over the chunk of the client's weight. With the work moving to us, the front desk staff is left with the obligation of directing of our team. With decreased motion at the front desk staffs, the client carves out opportunity to assemble client affinity which converts into limit for accomplishment of improved specialist patient relationship. Our Virtual Help arrangement covers the administrations recorded thus.
Insurance verification
It's a compulsion procedure for the Doctor’s office and hospitals to verify the patient eligibility and benefits details before rendering the service to the patients. This would nullify unnecessary denials and delay in payments from insurance carriers, unless otherwise the patient is a self-pay. There is no exact statistics on the amount of $ lost by hospitals and doctors office due incorrect or no insurance verification done on patient eligibility and benefits every year. It's also leads to stressed relation between office staffs and patient when followed up for bill payments and reminders. If a correct eligibility and benefit verification is done in the first place would result in clean claim payments from insurance carrier and good patient relation.
Verifying patient eligibility and benefits detail is always first step for a healthy revenue management for doctor’s office. This would ensure the patient of their responsibilities on covered benefits and non-covered charges at the time of appointment scheduling. By doing this it is not only helps the doctor’s office to decide on the course of treatment and also ensures the full reimbursement for their service rendered as per insurance fee schedule.
Outsourcing patient eligibility and benefits verification service to MF :
Clean claim submission
Lesser EDI rejections
Pre-approval service done easier
Healthy revenue cycle
Reduces A/R days.
Stream lined cash flow by reducing write-offs and denials.
Lesser patient follow-ups, reminders and last minute appointment cancellations.
By verifying patient coverage and benefits you can void the following claim denials.
No coverage: The extent to which patient insurance policy will pay for services provided by the doctor. Benefits may describe what portion of the allowed amount may be due from you, the level to which they will pay for services provided by various providers, and what types of services they will or will not cover. Policy termed prior to date of service or policy coverage starts after the date of service, either way provider will not get reimbursement for the service from insurance.
PIP / Auto coverage: When it comes to PIP/Auto accident coverage and benefits verification it’s a very tedious and lengthy process as it differ from state to state. Need to submit valid set documents to get the approval.
Health insurance rider: PIP/Auto coverage may deny benefits stating patient has health insurance rider. Simply put, a rider provides additional coverage and added protection against risks. A rider allows you to pay extra to broaden your standard coverage. Many patient are not aware about it, just to reduce the premium amount of auto insurance they ignorantly sign up health insurance rider.
Deductible not met: Deductible is the amount that a policy holder has to pay before the insurance company starts paying up. In other words, the insurance company is liable to pay the claim amount only when it exceeds the deductible. The amount of money that patient agrees to pay during the claim process. Here is a typical non-payment of claims processed and rolled over to patent responsibility. The patient would not have paid the said annual deductible amount by the insurance carrier for the insurance cover to the service or may have paid the partial amount of the deductible which may not cover the service. Another common error often goes un-noticed when verifying patient coverage for provider who is non-contracted with insurance carrier is out of network deductible not met by the patient? For patients under PPO/EPO/POS/ HMO options/ Indemnity plans they have out of network benefits options open. When verifying the benefits for out of network coverage most agents and patient quote that annual deductible is met but still the claim gets denied for payment. Actually when looking into the issue, is deductible met? YES and patient would also say refer the same that he/she has paid the annual deductible but technically NO. Front desk staffs often fail to understand that there are two diversified deductibles when comes to the above said plans, INNETWORK and OUT OF NETWORK deductible. When patient choose to see a non-contracted provider, patient has to satisfy the out of network deductible as well, so that insurance carrier covers the medical expenses incurred. This were the mistake happens, patients would strongly refer that he/she has met the deductible and front desk staff believe the same, actually here patient refers to the INNETWORK deductible that was met but not the OUT OF NEWORK deductible which they are not aware.
Maximum Benefits Used: Maximum Benefit exhausted in insurance coverage refers to the maximum amount of money/maximum number of visits/maximum number of units met as per the patient plan policy. Insurance carrier would cover maximum service pertained to $dollar value/ number of visits/frequency. E.g. Insurance would cover 15 chiro manipulation visits and 20 physical therapy visits annually or would cover $2000.00 of both chiro and PT annually, any visit after that will not be a covered expense. It is always recommendable to check whether any of the $$dollar/visits used up before render the medical service.
Non Covered Service: A non-covered service in means one that is not covered by government and private payers. Medicare Non-covered Services. The four categories of items and services that Medicare does not cover are: Medically unreasonable and unnecessary services and supplies. Non-covered items and services. Not all procedures and medical expenses are covered by insurance carrier. As per patients plan insurance would determine whether or not a covered service. E.g. Medicare does not cover any x-rays, scans taken by chiro. Medicare’s chiropractic benefit will be determined by your medical need. Most insurance carrier does not cover cosmetic surgeries. Some patients plan only cover major medicals and no routine visits or follow-up visits are covered.
No prior Authorization: Prior authorization or pre-authorization is a requirement from health insurance companies to ensure costly procedures are medically necessary. Doctors or medical providers are required to obtain prior approval before proceeding with a variety of procedures, diagnostics, medical devices, and prescription medications. As per patients plan certain procedures requires a prior approval from insurance carrier and it’s the provider responsibility to obtain authorization on time. Before rendering the service to the patient doctor's office ensure the procedure requires authorization or not from the insurance carrier. Even a simple office visit would get denied for no prior approval in certain patient's plan.
Outsource patient appointment scheduling to MF
Proper management of the medical appointment scheduling process contributes to the betterment of a medical practice in terms of efficiency and economy. It is a fact that many medical practitioners have entered the medical profession not just for the satisfaction of bettering the health of a number of patients but because of the great monetary gains. Streamlining of the appointment scheduling process would ensure that the healthcare provider can spend more time with the patients, increasing patient satisfaction and revenue.
Managing properly appointment scheduling of incoming patient adds to the improvement of a medical healthcare practice in terms of efficiency and economy. It is a fact that many healthcare practitioners have enrolled in the medical science profession not only for the satisfaction of betterment of patient’s health and community service also for the good monetary gains. Streamlining of the appointment scheduling process would ensure that the doctors can spend more time with the patient and see more patients per day and increasing patient satisfaction, reference and revenue.
MF - Patient appointment scheduling.
Calling and scheduling the patient for next visit
Answering patient queries on the availability of doctor and free slots
Advantages in outsourcing patient scheduling to MF
Helps to ensure the availability of the doctor, medical assistants, nurses, and other resources at the healthcare facility.
Doctor’s Office can easily find the earliest vacant scheduled time, in a day or week
Repeating appointments can be scheduled easily
Patients reminders, in sufficient advance, of upcoming appointments
Appointment cancellation and rescheduling handling at ease.
Tracking referring physicians and insurance coverage
Less scheduling errors and cuts down no-shows
MF provides best of the virtual assistance solution for any organizational requirement. If you are interested to outsource your front desk VA service to MF please send us an inquiry and we’ll get back to you with apt solution.
