Digitally verify healthcare insurance eligibility, coverage and benefits

Nearly 50% of patients say that a clear estimate of financial responsibility will impact whether they will see a particular Provider or not, and 70% of patients are more likely to pay if they receive an estimate on the day of service.

Eligibility and insurance verification are critical to guarantee accurate and timely receipt of insurance coverage information. If required checks and balances are not in place, a healthcare organization could be wasting money. Due to ineffective eligibility and benefits verification and/or prior authorization processes, late payments and rejections can occur, leading in decreased collections and revenues.

As it is a crucial step in the initial stages of the revenue cycle management and medical billing. This would tell us how much the insurance will be able to cover for the costs of the services provided to the patient. Thus, we can inform the patients upfront, for the charges that they have to bear, if any. This would speed up the money inflow avoiding denials

Trignohealth’s Insurance Eligibility Verification services enable real-time or batch verification, claim status monitoring and fraud mitigation. The healthcare insurance eligibility verification solution checks the status of your patient’s deductibles and co-pays based on their coverage – across the billing process – from scheduling and pre-registration to registration and discharge.

Medical Insurance Eligibility Verification Services For The Healthcare Industry

We have been in the medical billing and coding industry for over 8 years and have worked with several clients around the globe. We understand the importance of accurate verification of medical insurance claims for an insurance provider and ensure that our services are precise. Our offerings include -

Document Checking:-

When we receive the documents from the healthcare organizations/insurance providers, we thoroughly analyze all the documents and verify them against the list of necessary documents. This process helps us organize the documents as needed by the insurance company.

Verifying Patient's Insurance Coverage:-

We verify insurance E&B and insurance coverage details of the patient with the primary and secondary payers either by contacting them directly or by checking their official online insurance portals a day before the scheduled patient encounter. Then we capture and update details in the patient notes - co-pay, deductible, co-insurance, in-network and out-of-network benefits, and PCP name matching.

Patient Follow-up:-

If required, we promptly contact the patient for a follow-up encounter to seek any missing or incorrect information and get the required authorization as a part of our service procedure check. This helps in keeping track of all the information and cross verifying these details before the final submission is made.

Final Submission:-

We provide the client with the final results, which include the information about patient's eligibility and benefits along with other details, such as group ID, member ID, start and end dates of the insurance coverage, copay information, etc.

Benefits of Insurance Verification Services

The necessity for insurance eligibility verification services is one of the biggest questions from most healthcare organizations. Verifying the medical insurance eligibility of patients is of utmost importance as it directly affects the cash flow of these organizations.

Improves Cash Flow :- When there is access to updated eligibility data, the chances of getting the claims quickly accepted and processed are also high. This helps in maintaining a constant cash flow into the organization by reducing denials and write-offs and increasing patient satisfaction.

Streamlines Workflow :- Eligibility responses are consistently and concisely viewed, which improves the overall efficiency of the process. Following such a consistent and streamlined approach will lead to superior patient experience and fewer denials.

Boosts Self-pay Revenue :- By electronically matching self-pay patients with managed Medicaid databases, healthcare providers can get additional reimbursement opportunities. This also helps in identifying patients who unknowingly have coverage, reclassifying them, and submitting their claims, which frees self-pay patients from financial burdens.

With robust features such as real-time processing, HIS integration and 24/7 support, the solution seamlessly integrates with your EHR and EMR systems for enhanced decision making and superior financial outcomes.