Automated Patient Eligibility Checks: Why It Matters?

A doctor checks for patient eligibility using the laptop

Verifying patient eligibility is incredibly important for today’s healthcare practices. The manual verification process will be complex and time-consuming. Your front office staff needs to spend too much of their time tracking down payer information and eligibility. So, the right solution providers need in today’s tech world is automated patient eligibility verification to better help their patients in the medical billing process. Here is why automated eligibility check is important and how it benefits healthcare practices.

Benefits of Automated Patient Eligibility Checks

Streamline Check-in and Billing

Automated patient eligibility is completed at check-in. Having this information automatically, at the start of the visit, streamlines the check-in and billing processes. Once coverage is verified, providers can proceed with their planned visit and have peace of mind that their payment is on the way. Should a patient not be covered for services, they can learn more about what their out-of-pocket cost will be for their visit. This creates transparency throughout the billing process that patients love to see from their providers.


Time Management

Your front-line staff is historically responsible for manual verification. This means like a member of your team is tasked with verifying patient eligibility. This involves calling their insurance company to verify that the information the patient provided is correct and that the services they are requesting are covered.

With automated patient eligibility checks, your staff and better manage and use their time. Rather than spending hours of their day chasing down payer information, they can focus on more patient-critical tasks. Automated tools ensure that your team still has the information you need right away.

Simplify Claims Management

Implementing an automated patient eligibility checking tool will also help simplify claims management within your organization. Denials are the number one cause of delayed payment. With known eligibility, providers can improve their clean claims and decrease their overall number of denials. More clean claims mean more payments for your practice.


Increase Patient Payments

Automated patient eligibility verification also helps to bring in more patient payments. This tool creates transparency in the cost of care at the start of a visit. Rather than be caught off guard by the cost of their care, patients can better prepare.

Transparency throughout the medical billing process is what helps your patients feel confident in their ability to pay those bills. Should a patient find that the cost of services equals too much, other options can be discussed with their provider. Either way, this tool improves the patient experience and keeps your accounts out of A/R.

Visibility and Patient Satisfaction

In addition to the numerous financial benefits, up-front patient eligibility verification allows for greater visibility between you and your patients. Armed with the information they need, your staff is capable of educating your patients ahead of time on the billing process with their insurance plan and what, potentially, they will owe you for the visit. The result is happier patients and fewer contested bills.

Get Started With CapMinds Medical Billing Services

Being one of the top 10 medical billing companies, CapMinds offers the best medical billing services to clients across the nation and increases your business revenue. If you are interested in outsourcing your medical billing services, we help you to improve the medical billing processes with our trustable outsourcing services.

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