Before the patient's visit to the provider, we perform pre-insurance verification to check eligibility regarding the particular insurance, the requirement for any pre-authorization or referral, whether any copayment has to be collected, if the patient has met the deductible, the amount of co-insurance the patient shares, and whether the patient's insurance covers the service sought from the provider. This step is important because many insurance providers do not provide retro-authorization.
Pre-registration services ensure that our clients don't spend their time collecting patient information or scheduling appointments. Our clients utilize their pre-registration staff for other activities that have a direct impact on the healthcare system at their hospitals or clinics. Starting from the careful input of patient demographics in an accurate and timely manner, we validate patient information, registers patients, and updates records.
These steps in the revenue cycle management are critical. Obtaining pre-authorizations or ensuring you have a referral can provide several advantages:
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Accountability and cost containment
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Reduction of denials and enhanced collections
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Reduction in write-offs
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Increase in revenue
The process for obtaining prior authorizations and referrals can be done in many ways such as:
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Phone calls
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Online forms
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Faxes sent through PMS
All of these take time and add an administrative burden on your staff! Time that could be better spent ensuring the quality of patient care is delivered and maximized. Also, your staff needs to be aware of a variety of different payer’s guidelines, which continually change. Staying ahead of all of these changes is time-consuming as well.
Billed Right helps save you time and reduce your denials!