Eligible to Bill?
Cursing out insurance companies is a commonality in my field of work. From all of my meetings and conferences with healthcare professionals there always seems to be the underlying theme of how can I make more money as a healthcare professional? The answer is not simple, however, the answer does lie in one fundamental ideal, discipline. Discipline is often overlooked in healthcare. Another ideal that compliments discipline is preparation, all healthcare providers know this ideal very well for if they didn't they would never attain the role of a provider.
Most providers assume that getting paid by insurance companies comes from a good billing system, billing staff, or billing company. While this does greatly affect your income there is a much more important part of your practice or clinic that will affect your bottom line. Eligibility or in a broader sense admissions is the key to any success in healthcare. It is the admissions process that will dictate whether you will be paid quickly or paid in 6 months or not at all. Most practices and some clinics don't perform this vital task at all and it is the leading reason for most denials.
In our company we have a rule called the 30:60 rule, this rule states that the 30 seconds you take to check eligibility will save you 60 minutes of follow-up work in the future. Some of you may say that there is no way it takes only 30 seconds to perform eligibility, and you may be right in some cases, however, if you leverage technology, the average time to perform eligibility should only be around 30 seconds per patient.
This is where discipline comes in, it is very easy to say to your staff, we need to check eligibility for every patient that comes in; it is another thing to actually check each patient including your patients that have been coming for 30 years. Nowadays people are changing insurances more times than they change their diets. It is very easy for your staff to become lazy or get caught up in the very hectic day-to-day operations of a practice or clinic, nevertheless, it is something that must be done to ensure you are paid for every service you provide.
Below are some helpful ideas to maintain this all-important function:
Now you must ask yourself, how eligible are you to bill?
Email me: firstname.lastname@example.org