Scheduling, Eligibility Verification, and Pre- Authorization
The planning administration offers uncommonly skilled staff, with adaptable staffing timetables to oversee call stream for arrangements. The irregularity factor is incorporated into the staffing plan to guarantee that we are not dismissing any patients. The setting up plan is arranged in accordance with the irregularity and can increase at short notification to deal with the patient stream for a predominant patient encounter.
Effectively overseeing patient stream takes thought and cautious arranging. It is by a long shot quite possibly the most difficult part of training the board. In any case, when done accurately, smoothing the patient timetable will build the limit and effectiveness of your training without expanding your overhead.
Eligibility Verification and Pre- Authorization
With the Affordable Care Act, protection and qualification check is totally basic. Without appropriate qualification and advantage confirmation, incalculable downstream issues are made postponed installments, revamps, diminished patient fulfillment, expanded blunders, and default.
A 2009 McKinsey Quarterly study of retail medical services shoppers showed that 52% of customers would pay from $200 to $500 or more by credit or check card when they visit a doctor if a gauge was given at the place of care.
To stay away from these issues, Virtual Oplossing Healthcare gives a distantly facilitated Centralized Eligibility Unit for emergency clinics, personnel practice plans, PMS/EMR merchants, and charging organizations. The arrangement comprises of Virtual Oplossing staff, innovation, the executives and skill that conveys top caliber, savvy patient protection qualification and related administrations.
Our services have the potential to:
- Improve A/R Cycles.
- Increase cash collections by reducing write-offs and denials.
- Eligibility and Benefits Verification
- Receive schedules from the hospital via EDI, email or fax.
- Verify coverage on all primary and secondary (if applicable) payers by utilizing sites like WebMD, payer.
- websites, interactive voice response systems, and phone calls to payers.
- Contact patients to get updated insurance information.
- Provide the clients with the results, which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information, and much more.
- Obtain pre-authorization number.
- Obtain a referral from PCP.
- Enter/update patient demographics.
- Remind the patient of POS collection requirements.
- Inform client if there is an issue with coverage or authorization.
- Process Medicaid enrollment.