Insurance Verification Services - Its Importance

For physicians, hospitals and healthcare institutions, who are in the business of saving lives, insurance benefit verification is a time consuming task. Insurance verification services are a crucial part of the medical billing process and play a major role in the healthcare provider's claims denial management program. Offered by professional medical billing companies, health insurance verification services help group and specialty practices and hospitals to check a patient's active coverage with the insurance company and verify whether the patient is eligible for scheduled medical procedures.
Eligibility verification process has to be carried out before the patient is admitted to a hospital. Services provided cover the verification of payable benefits, co-pays, co-insurances, deductibles, effective date, patient policy status, type of plan and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum, and more.
Insurance eligibility verification is a necessary step in the medical billing process. There are many reasons that make health insurance verification services a necessity. In order to avoid claim rejection, each healthcare provider has to verify the insurance eligibility and coverage benefits of the patients, before the patient is provided medical services. Or else, it might lead to problems such as delayed payments, increased errors, need for rework, non-payment of claims, patient dissatisfaction and more.
Non-verification of insurance eligibility would lead to problems such as delayed payments, rework, increased errors and patient dissatisfaction. All this underlines the importance of insurance verification in healthcare.
Insurance Verification Services for Speedy Reimbursement
Outsourcing insurance verification services would be a good option for health care professionals who do not have the time to spare on insurance benefit verification. The benefits of outsourcing medical insurance verification are:

• Faster billing cycles
• Speedy approval and authorization
• Simplified workflow
• Reduced risk
• Reduced number of returned claims
• Improved payment and collections

Health insurance verification specialists, called insurance verifiers, are assigned by the medical billing company to work closely with providers and patients. They will work with patients, complete paperwork, and verify patient information with the insurance carrier to maximize reimbursement and improve the revenue cycle. They will also carry out all follow-up processes, ensure that requirements are met and send back the results to the provider. They will also communicate with the insurance provider to communicate missing information, appeals, and other relevant things. The insurance eligibility verification process involves many steps:

• Receiving patient schedules from the hospital or clinics via FTP, email or fax
• Verifying patients' insurance coverage on all primary and secondary (if applicable) payers
• Verifying demographic information
• Updating patient accounts
• Contacting patients for additional information if necessary
• Updating the billing system with eligibility and benefits details such as member ID, group ID, coverage start and end dates, co-pay information

Insurance verification services and its importance in healthcare industry demand the involvement of professionals for a successful outcome.

Medical Insurance Verification - Factors That Contribute Towards Improving Productivity and Profit

Medical insurance verification is a necessary part of the medical billing process. It involves checking the eligibility of patients to receive payment for their insurance claims. Such verification is one of the most critical steps in claims management. Unless medical insurance is verified prior to providing services, payment for claims cannot be ensured. Busy healthcare practices now find that they can improve productivity and profit to a great extent by outsourcing medical insurance verification to a professional company.
Medical practitioners that partner with medical billing firms to handle eligibility verification save the money and time that would be necessary to perform the job in the practice. Health insurance verification is a key element in the extensive array of services that a medical billing and coding company usually offers. A separate team is assigned the task of verification of patient insurance eligibility - right from receiving patient details, checking them and contacting the insurance companies. Services offered would include
• Receiving patient schedules from the hospital
• Verifying insurance coverage on all primary and secondary payers
• Contacting patients for further details if needed
• Providing the medical practice with all the necessary information: eligibility and benefits information, member IDs, co-pay information and more
Insurance Verification Services to Enhance Profit and Improve Productivity
Insurance verification services play a vital role in the revenue cycle. By outsourcing these tasks, the medical practice does not have to hire staff to do the job. This helps save on salaries, employee benefits such as payroll taxes, paid vacation time, medical office space, health insurance, workers' compensation insurance and much more. In addition, much is saved on management and administrative costs, office space and utilities, technical support and other related aspects. All these savings help enhance the healthcare provider's profits.
Insurance verification outsourcing also helps healthcare professionals save valuable time, focus on their core business activities and provide quality healthcare. This helps maximize their productivity, which ultimately results in increased revenue. As the verification services are performed by experts, the process is hassle-free. This reduces the chance of claim denials and helps the revenue and profit of the practice.
Factors That Help Enhance Profit and Productivity
Medical insurance benefit verification services help increase profit and productivity by
• Sharing business risk: Outsourcing these tasks to a reliable service medical billing company reduces business risks due to changes in technology, government policies, and market trends. This helps medical professionals to concentrate on their core activities which results in better productivity and profit.
• Ensuring accuracy: The risk of errors in verification is reduced when a professional team handles the job.
• Reducing operating cost: The services help to considerably reduce the operational costs and capital investment of the practice.
• Quickening reimbursements: Timely and error-free health insurance verification ensures efficiency and speed in the submission of medical claims. This can speed up the medical reimbursement process.
In summary, medical insurance verification increases the revenue of healthcare practices by speeding up the insurance verification and authorization process. This would ensure maximization claim reimbursement.

Different Types of Cloud Systems for Insurance

One of the transformational concepts sweeping the software world is that of cloud computing. "Software in the Cloud" is an expression being heard with increasing frequency as companies in every industry move to adopt a delivery model which is more cost efficient than traditional software delivery models. Cloud computing is now seen as a safe and secure option to enable business and IT to focus on core competencies.
But what exactly does "cloud computing" mean and how is it transforming the ability to launch, maintain and expand software in ways not even conceived of a decade ago? This document addresses many of the most common questions we have encountered in our 15 years of commercializing cloud-based software for the insurance industry.
"Software in the Cloud" is an expression being heard with increasing frequency as companies in every industry move to adopt a delivery model which is more cost efficient than traditional software delivery models. Cloud computing is now seen as a safe and secure option to enable business and IT to focus on core competencies.
But what exactly does "cloud computing" mean and how is it transforming the ability to launch, maintain and expand software in ways not even conceived of a decade ago? This document describes three different types of cloud computing:
Software as a Service (SaaS)
Software as a Service is a delivery model where a company relies on an outside provider to deliver software solutions over the internet which users typically access through a web browser. This model allows the software to be easily and securely accessed from anywhere in the world without the traditional cost and time requirements to provision the remote connectivity and installation.
A consumption based fee structure is most frequently associated with SaaS solutions. This creates advantages over the deployed implementation as the initial costs are significantly reduced and the time-frame to deploy new significantly shortened. SaaS pricing models also reduce the financial risks associated with the software purchase by deferring fees until the implementation proves successful and by keeping internal IT costs to a minimum. The ROI calculations become easier with the SaaS model as the capital and operating costs can more easily be matched against the associated revenue streams. SaaS contracts are also typically of a shorter duration than traditional software and often come with early cancellation provisions. Finally, the SaaS model engenders a deeper partnership between vendor and customer as the financial interests of both are aligned to achieve a quick successful implementation.
Platform as a Service (PaaS)
Platform as a Service is a delivery model where the computing platform (network, servers, storage and other services) and solution stack are provided as a service. The infrastructure and development tools needed to build, test and run applications are delivered by the cloud provider over the Internet.
With PaaS, ISVs and corporate IT departments can focus on innovation instead of complex infrastructure. By leveraging the PaaS, organizations can redirect a significant portion of their budgets from "keeping the lights on" to creating applications that provide real business value.
Infrastructure as a Service (IaaS)
Infrastructure as a Service is a model in which an organization outsources the equipment used to support operations, including storage, hardware, servers and networking components. The cloud service provider owns the equipment and is responsible for housing, running and maintaining it. The client typically pays on a per-use basis. One of the key advantages of IaaS is scalable growth without the need to buy new servers or hardware.