decisionhealth Newsletters, Part B News - 2017 Issue 9 (September)
Spruce up insurance verification to speed processing, prevent post-encounter billing
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Article Overview
This article is for medical practice administrators, billers, coders, and revenue cycle staff who handle eligibility checks and patient intake. It explains how electronic eligibility transactions, practice management system features, and workflow adjustments can help practices gather better insurance information before the visit and reduce avoidable post-encounter billing issues. The discussion focuses on general verification processes, staff workflow, and technology-supported intake improvements rather than code selection.
Why This Topic Matters
Accurate insurance verification affects collection timing, patient financial communication, and administrative efficiency. Practices that use available eligibility tools and cleaner intake workflows may reduce billing surprises and avoid unnecessary follow-up work after the encounter.
Article Sections
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Insurance verification timing and system use
Overview of open enrollment timing and the role of electronic eligibility transactions in verifying coverage before the visit. The section also notes common reasons some practices do not fully use these tools.
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Check for tech tools
Discussion of practice management system features and other technology options that can support eligibility follow-up, patient financial estimates, and payment setup. The section emphasizes awareness and activation of existing tools.
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3 more intake tips
Additional workflow suggestions for improving pre-visit verification, discussing payment alternatives, and supporting front-desk data entry accuracy. The section focuses on operational process improvements.
What You Will Learn
- How electronic eligibility verification fits into front-end revenue cycle workflows
- What kinds of practice management tools can support insurance intake and follow-up
- Ways practices can organize verification tasks ahead of patient visits
- How front-desk workflow and accuracy checks can affect insurance data quality
Who Should Read This
- Medical practice managers
- Billing and collections staff
- Front-desk and registration teams
- Revenue cycle administrators
- Healthcare consultants
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