ULTIMATE GUIDE TO OUTSOURCING MEDICAL ELIGIBILITY VERIFICATION

Posted by Aqkode Healthcare Solution LLC on August 20th, 2022

Introduction:

Outsourcing Medical Eligibility Verification

Outsourcing medical eligibility verification is a process where a provider arranges for a third party to verify the healthcare insurance eligibility of a patient prior to an initial appointment or an appointment for a procedure.

A medical eligibility verifier may be a physician, nurse, or medical biller.

This article will provide you with information on how to get started with outsourcing medical eligibility verification and what are the benefits of this process.

What is Medical Eligibility Verification?

Medical Eligibility Verification is a process in which the medical records, plan information, and demographic information of a patient is verified for the provider by the medical biller with the insurer to determine if a particular patient is eligible for the medical service the patient is scheduled to receive.

If eligibility cannot be determined from the information provided on the application, then additional documentation may be requested.

What are the Benefits of Outsourcing?

Outsourcing is becoming a popular solution for businesses that want to reduce their costs, increase productivity, and improve their time management.

Hiring a Healthcare Process Outsourcing (HPO) is the act of hiring an external expert to do work that your in-house team cannot or does not have the capacity to do. It can be for anything billing, coding, eligibility verification, pre/post-authorization, AR follow-up, rejection/denial management, payment posting backend office work to frontend office work like scheduling.

Some of the benefits of outsourcing are: – Hiring HPO with specific skillsets -Cost savings -Increased productivity -Improved time management.

Best Practices for Hiring a Medical Billing Company for Outsource Service

The first thing to do is to make sure that the billing company you hire has a good reputation. You can check reviews, testimonials, and ratings from other clients. This will help you get a better idea of the quality of service that you are getting and whether it will be worth your time and money.

Next, find out what services they offer and how much they charge for them. Some may offer a lot more services than others, so it’s important to know what you are paying for before hiring them.

Finally, make sure that they have the right skill set for your needs. For example, if you need help with coding then it would be best to hire a company with multiple AAPC-certified coders on staff instead of one without any coders on staff.

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