5 Ways Patient Eligibility Verification Positively Impacts RCM

Revenue cycle management (RCM) is the financial process healthcare providers use to track the financial aspects of patient care. It starts with registration, continues through appointment scheduling, and concludes at the final balance payment. Understanding and optimizing RCM can enhance a practice’s accuracy, reduce delays, and improve financial health. Performing patient eligibility verification during scheduling and just before the visit is integral in effective revenue cycle management. This article will highlight five advantages of using software to verify patient eligibility that will positively impact your revenue cycle.

No. 1: Faster Payment Process

Patient eligibility verification software hastens upfront patient payment by allowing providers to check insurance eligibility easily before any treatment is given. The result is less work for staff, fewer mistakes, and fewer denied claims. 

No. 2: Eliminate Manual Verification

A clearinghouse is an intermediary between healthcare providers and insurance payers to exchange information. If a clearinghouse has a built-in verification l product, it can streamline the verification and billing processes significantly. Using this product instead of manually verifying patient eligibility will result in reduced mistakes while gathering pertinent benefit information. Leveraging a software solution also ensures that the data being transmitted is accurate, and can be processed quickly, and in many cases real-time.

No. 3: Revenue Loss Prevention for Better Financial Health

Your practice needs accurate eligibility and verification processes to prevent revenue loss. Complete patient eligibility verification ensures that all patient information is correct right from the start. Modern eligibility verification software plays a vital role in this process. Effective verification processes directly lead to fewer claims rejections and more approvals. Accurately verifying patient eligibility before treatment ensures that submitted medical claims align with insurance policies and patient coverages.

Some common pitfalls that lead to claims being rejected include: 

• Incorrect patient information
• Lapse in coverage
• Billing for non-covered services

Accuracy in the initial stages helps avoid these issues. The result is a streamlined revenue cycle and reduced administrative burden by not having to reprocess  rejected claims. The bottom line is that improving insurance eligibility verification can lead to more accepted claims, and that’s a benefit for everyone.

No. 4: Stay Compliant to Avoid Regulatory Penalties

Accurately verifying insurance eligibility is vital in helping healthcare providers stay compliant with regulations. Accurate verification ensures that providers can avoid the costly penalties associated with non-compliance. Some of these penalties include:

• Fines
• Legal actions
• Damaged reputation

It is vital to have policies that prevent billing errors that can lead to audits and sanctions from regulatory bodies.

No. 5: Increased Patient Satisfaction and Retention

Trust is one of the most essential factors in the relationship between patients and their providers. When healthcare providers verify insurance eligibility before treatment, patients are more likely to trust their healthcare provider because they avoid unexpected charges on their bil. This practice is key to patient satisfaction.

Patient satisfaction can result in higher patient retention rates as patients return for future services and may even recommend a provider to acquaintances. The relationship between well-managed insurance verification and patient satisfaction is essential.

Optimize RCM with Office Ally

Seeing the importance of integrating efficient eligibility verification software is only the first step, but how can you implement these processes in your practice? Office Ally is here to help. Office Ally has eligibility verification software that emphasizes accuracy, security, and efficiency. This product, available in Office Ally’s Service Center, Practice Mate, and EHR 24/7 solutions, allows you to check eligibility and benefits in real-time, making revenue cycle management more efficient and less error-prone.

A partnership with Office Ally opens the doors for your practice to improve patient retention, increase revenue, and comply with healthcare regulations. Incorporate Office Ally’s solutions today to improve your RCM and experience the benefits of a verification system.