Insurance Verifications and Authorizations Outsourcing: Simplified Workflow

Insurance verifications and authorizations comprise an important part of the insurance claims cycle. Many healthcare professionals cannot find time to attend to these vital tasks, especially when they are caught up in other core activities. In the absence of accurate insurance eligibility verification, countless problems arise including delayed payments, increased errors, rework, patient dissatisfaction and nonpayment. Outsourcing firms can help in this scenario with dedicated and timely services that will help simplify workflow.

Outsourcing medical insurance verification will not only reduce the workload of physicians but also make their practices more efficient. Today, there are several outsourcing companies that allow healthcare facilities to benefit from insurance eligibility verification specialists.  These professionals can handle all aspects of insurance benefit verification and insurance authorizations, thus relieving medical professionals from related administrative responsibilities. This gives physicians enough time to cater to the needs of their patients and focus more on core business activities.

Maximize Reimbursement and Minimize Denials

Known also as health insurance verification specialist, an insurance verifier works with patients, completes paperwork, and verifies patient information with the insurance carrier to maximize reimbursement and facilitate revenue cycle improvement. The service provided includes verification of payable benefits, co-pays, co-insurances, deductibles, patient policy status, effective date, type of plan and coverage details; plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum, and more.

A medical billing company with long term experience in the field will work as an extension to its client’s office, making its services available round the clock. In addition to lessening the workload of healthcare staff, outsourcing insurance verifications and authorizations offers other concrete benefits which include:

•    Streamlines business operations
•    Reduces risk factors
•    Simplifies workflow
•    Fewer claim rejections
•    Reduces paperwork
•    Co-ordinates all requests and communication with insurance companies regarding pending or missing requests
•    Would let you maintain your authorization records electronically
•    Faster billing cycles
•    Reduces payment delays
•    Reduces the number of denied claims
•    Considerable increase in productivity
•    Frees up workforce to focus on more productive tasks
•    Improves payment and collections
•    Speeds up approval and authorization
•    Maximizes office efficiency and economies of scale
•    Allows you to check the status of your application online

Professional Medical Billing Company for Prompt Service

Medical entities should ensure that they request insurance verification services only from professional companies in the field. Only a reliable company can help in meeting various complex insurance verifications and authorizations demands promptly. Once the reliability of the service provider has been confirmed, just inform them about your requirements and provide them with the required clinical documents, and you can be assured that the authorizations would come to you without any hassles. Medical professionals get to enjoy simplified workflow and tremendous stress relief with the major insurance verification and authorization processes streamlined.

Benefits of Outsourcing Insurance Verification Processes to a Reliable Provider

Manage Your Insurance Claims Efficiently

Verifying insurance eligibility is very important as it is an essential process in medical billing. Efficiently carried out insurance eligibility verification will ensure that the services you provide are covered. You stand to gain from improved reimbursement as well as patient satisfaction. However, many healthcare professionals find it difficult to carry out flawless insurance verification amidst their busy schedules, with their staff engaged in many administrative processes. This situation leads to problems including delayed payments, nonpayment of claims and eventually, patient dissatisfaction. Availing of insurance verification services offered by a reliable BPO firm is a practical option in such an instance. Health insurance verification specialists in these firms can be extremely helpful in this regard by providing professional services.

Today, there are several outsourcing companies proficient enough to do your necessary paperwork on time and ensure timely reimbursement. They will work with patients and healthcare staff and take care of the entire process right from making calls to the local insurance agencies and following up with them to getting the documentation done in the end. With various service providers in the field, obtaining insurance verifications is now easy for healthcare facilities including hospitals, clinics, medical groups as well as individual physicians. 

Benefits Ensured

Listed here are some of the benefits of outsourcing insurance eligibility verification.

•    Streamlines business operations
•    You can focus on core business activities 
•    Reduces your risk factors
•    Reduces effort
•    Simplifies workflow
•    Fewer claim rejections
•    Reduces paperwork
•    Provides access to specialized services
•    Faster billing cycles
•    Enhances the flexibility of your organization
•    Minimizes delays considerably
•    Improved staff productivity
•    Maximizes office efficiency and economies of scale
•    Reduced rework of claims

Make Your Practice More Efficient

Outsourcing insurance verification will release you from the stress and strain of doing this complex process in-house. It frees up your workforce to focus on more productive tasks, and at the same time improves your payment and collections. Your partnering firm will focus on speeding up approval and authorization and co-ordinate all requests and communication with insurance companies regarding pending or missing requests. Outsourcing enables you to have better control of your business. It will make your practice more efficient and ensure smooth functioning with more relaxed staff and streamlined business processes. For the best results, take care to outsource insurance benefit verification to a reliable firm with a good reputation. A reputable medical billing company will make available the services of a team of qualified insurance verifiers who have extensive knowledge of insurance, healthcare terminology, and medical/surgical techniques.

With insurance verification processes entrusted to reliable hands, you can concentrate on patient care and related core activities.

Medical Billing Services Help Physicians Focus on Core Medical Activities

Focus on Patient Care Instead of Struggling with Practice Administration

Today, outsourcing medical billing services is recognized as a long term competitive strategy for success. As the medical practices grow in size and operations, it is important that the physicians’ focus be redirected to core activities while the non-core functions such as carrying out medical coding and medical billing, and claims processing can be outsourced to medical billing companies specialized in providing professional medical coding and billing services.

By outsourcing these processes to medical billing outsourcing firms, healthcare practices can focus on their primary concern - patient care. Besides, these firms help physicians to submit medical bills and insurance claims on time, thereby significantly increasing their reimbursement. Medical billing services are available for almost all medical specialties including chiropractic, general surgery, oral and maxillofacial surgery, cardiology, dermatology, nuclear medicine, pediatrics, dentistry, radiology, family practice, occupational therapy, pain management, and others.

Services Provided by Medical Billing Companies

Listed here are some of the main services provided by a medical billing company.

•    Patient statement creation and mailing
•    Patient information collection and analysis
•    Medical insurance claims processing
•    Solving the billing queries personally
•    Insurance verification and insurance authorizations
•    Continuous monitoring and follow up of rejected claims and resubmission after resolving any problems
•    Customized reporting to track business activity and productivity
•    Credit bureau reporting
•    Generates reports with details of payments and claims, which helps you in adjusting your billing practices and improving cash flow

Apart from the above, a reliable medical billing firm will provide regular quality checks to ensure flawless claims. You can also request for services such as charge entry, cash posting and reconciliation, scheduling and rescheduling, AR collections and continuous evaluation of accounts. Usually, established companies also provide 24/7 customer support and technical assistance.

Outsourcing medical coding and billing allows physicians to focus on core medical activities.  With efficient management of the entire billing process, claim denials will be minimum and practitioners will receive on time payment for the services they provide. Outsourcing also improves office efficiency with your staff getting more time to attend to other business processes.

Choose an Experienced Provider for the Best Solutions

More and more healthcare facilities now prefer to avail of medical billing services and medical coding services from dependable outsourcing firms. There are several large as well as small medical billing companies offering a wide range of services. However, when it comes to your medical billing and coding don't choose just any medical billing firm. Take your own time to choose an experienced provider for the best solutions.

Helpful Tips to Find Medical Coding Companies

Locating outsourcing companies that offer reliable medical coding services can be a complex task for healthcare entities, as numerous firms exist in the industry. Here are some tips that will help you find established medical coding companies that can provide professional medical coding solutions that perfectly suit your practice requirements.

Selecting Reliable Companies- Core Features to Look for

Medical coding tasks are to be performed with accuracy, as coding errors can lead to rejection or denial of reimbursement. Leading medical coding companies provide efficient coding solutions for all medical specialities. Consider the following tips when selecting a medical coding company.

Experience: Consider the experience of the particular outsourcing company you are interested in partnering with. Choosing a medical coding company with sufficient industry experience will help you obtain more accurate solutions, strictly adhering to the latest regulations formulated by the federal government and insurance companies.

Reliability: Ensure that your preferred company is reputable. Such firms can provide consistent services that will improve the revenue and cash flow of your practice.

Technological aspects: To provide client-focused medical coding solutions, medical coding outsourcing companies have to maintain state-of-the-art technology, innovative infrastructure, equipment, and advanced coding software like Ingenix, Flash Code and AMA software. Find out whether your firm is fully equipped with the necessary technology.

Services: It is necessary to evaluate the major medical coding services that are offered by your firm.  Most professional companies provide comprehensive medical coding solutions covering:

•    Hospital / in-patient coding
•    DRG/ICD-9-CM coding validations
•    Emergency room e-code evaluation
•    Medical coding audits
•    CPT medical coding, and more

Expertise and Consistency: Before signing up with a medical coding company, ensure that they have AAPC certified medical coding specialists proficient in CPT, ICD-9 CM, and HCPCS codes and standards. Further, check whether they can complete your specific medical coding tasks within your stipulated time limit.

Turnaround time: Confirm that the selected company can provide systematic medical coding solutions within minimum turnaround time. Timely submission of error-free insurance claims and medical bills will help obtain medical reimbursement in a timely manner.

Data privacy: Find out whether your medical coding company is HIPAA compliant and offers total security and confidentiality for patient data.

File transfer facility: Medical coding firms should maintain secure file transfer facilities. Ensure that your coding firm provides safe and secure file transfer options through 128-bit encrypted FTP or e-mail.

Pricing structure: Medical coding services are provided by various firms at different charges. Therefore, an assessment of their pricing structure will help assign the job to a reputable company providing effective solutions at competitive charges. Most well-known medical coding firms offer 30% - 40% cost savings as well.

See whether the firm offers free trial options, as this will enable you to assess their service quality, free of cost and take a decision.

Experienced Firms for Precise Solutions

Partnering with experienced medical coding companies ensures precise and quality medical coding solutions that will help maintain a steady revenue cycle for your medical practice. Organized medical coding services also bring in supplementary benefits such as:

•    Reduce claim denials and rejections
•    Enhance productivity and profitability of your practice
•    Minimize your operating outlay
•    Reduce your managerial workload

Web Resources Help your Search

To find reliable medical coding companies, you can utilize various web resources. Performing searches on online directories and yellow pages with zip code or the name of your city will give you a complete list of companies functioning in that location. Social networks and forums are the other resources that can help your search. Reading blogs, newsletters, articles and press releases will also direct you to the right company.