It’s crucial that medical care providers understand the importance of insurance verification services in the healthcare industry. It plays a major role in a hospital’s claims denial management program. Successful billing depends on successful eligibility verification. Health insurance verification is all about the process of checking a patient’s active coverage with the insurance company and verifying the eligibility of his or her insurance claims. In order to avoid claim rejection, the verification process must be done before the patient is admitted into a hospital. Otherwise, it might lead to denials.
Patients are ineligible for benefits when they provide wrong or outdated information or when their policies have been terminated or modified. A simple error can result in claim rejection or denial, so you have to be sure it is being done correctly. This tool helps ensure patients’ insurance eligibility before they come into your office, streamlining operations and preventing costly and frustrating mistakes.
The eClinicalWorks 10e offers a patient management system and patient flow tools that track patient encounters from check-in to departure. Physicians get automated billing tools to help them get reimbursed by payers. The eClinicalWorks EHR has the capability to integrate with its partner Emdeon that helps insurance verification by checking patients’ insurance eligibility in advance.
According to an MGMA report, 50 percent of medical claims are rejected due to insurance eligibility issues. The eClinicalWorks insurance eligibility team verifies the authorization and referral details of the patient. Then they inform the patient what copays or deductibles need to be paid prior to the visit.
Get our Price Guide for EHR SoftwareAllscripts provides a set of core EHR resources: Professional EHR, Touchworks EHR and Acute Care EHR, which vary in size and offerings. However, all three provide information on payments, patient flow, lab results and more in easy, visual dashboards.
Allscripts TouchWorks (the enterprise solution) displays the patient’s insurance provider name, but this is read-only information. BillingParadise (one of the main RCM add-ons to Allscripts offered in the more comprehensive subscriptions) offers eligibility verification services to aid users in simplifying and streamlining the patient ingress process at your practice.
eClinicalWorks EMR wins for this feature by providing interactive information displays and complete cycle management from check-in to departure at no additional fee.