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Four Ways Real Time Eligibility Affects Your Operations3 min read

Real Time Eligibility
Real-time eligibility verification instantly confirms coverage and benefits for efficient healthcare billing and improved patient experience.

Real time eligibility may have a beneficial or harmful influence on your practice. Angering patients and unpaid claims might result in improper management of the processes. You should concentrate on your practice’s real time eligibility procedure. 

Real Time Eligibility Check: What Is It?

Real time insurance eligibility verification is the process of electronically confirming a patient’s insurance coverage. It enables easy access to relevant information for claim processing. The four ways real time eligibility affects your workflow are highlighted. We’ll review its definition and give details about its benefits. 

Eligibility Verification’s Effects on Medical Billing

Here are the top 4 ways real time eligibility impacts the whole workflow of your practice.

1. Enhances Patient Satisfaction and Experience

Processing patient deductibles while dealing with frequent plan modifications takes time and effort. It gets demanding and tiresome to confirm your patients’ insurance and perks. These duties may become too many if real time eligibility processing is unreliable. 

The output of our medical team will decline. Lengthy processing delays will impact patient happiness and experience. Your productivity will double, and patient satisfaction will double. If done correctly, it affects your practice.

2. Pays You Off Faster

You can receive payment quicker if you can reduce holdups and rejections. According to studies, improper claim management or a lack of real time insurance eligibility verification processes are the usual reasons for claim delays and denials. You may submit the information pertinent to the payment procedure using this method.  Additionally, data collecting will be more precise. By entering only the important information, you may prevent recording erroneous, incorrect, or missing data. You’ll get paid more quickly if you do this correctly.

3. Enhanced Collections

Real time eligibility yields real time outcomes, as the word suggests. You may check their eligibility as soon as you schedule and register your patient for an appointment. The procedure swiftly eliminates uncollected income. Whether patients alter their registration information, payment method, or insurance verification, the procedure maximizes your collections. It also removes the possibility of future revenue loss. Consequently, your cash flow is significantly increased by collecting just the accurate payment and insurance information. 

4. More Time for Patient Care

Pushing your patients through the doors is what gives your medical practice life. Dealing with eligibility problems takes time. I’st in danger and compromises your treatment plans.

How to Determine Medical Billing Eligibility?

In order to determine eligibility and facilitate a smooth visit, it is necessary to gather the patient’s insurance information and status beforehand. This involves obtaining the patient’s insurance details, including copay updates if applicable. Verifying insurance updates is essential to ensure that the patient’s account is appropriately registered and expedites the check-in. Additionally, individuals are encouraged to coordinate their insured plans and notify their primary care physician. Each patient should provide the following information: their membership number, full name, gender, date of birth, and the subscriber’s name. It is also important to note the relationship between the patient and the subscriber, as well as the date of coverage (effective date) and the name and number of the group.

When to Examine Patient Eligibility?

When eligibility should be verified should be obvious. Healthcare professionals should always take the initiative. Before the appointment, it is important to check the eligibility coverage. Usually, 48 hours prior to the first appointment. The insurance validity can also be verified upon check-in as an option. Always request new information on the insurance from the last visit from the front desk staff or the remote medical team. 

Darren Straus
Darren Straus
Leverages expertise in RCM, medical billing, and coding to navigate the complexities of healthcare IT. I like to write about simplifying complex healthcare processes and empowering providers with efficient solutions.



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