Eligibility Verification of Insurance Benefits
As soon as the appointment is made, the patient's insurance information needs to be verified. Insurance information can change at any time, even for regular patients, and thus it is important that the provider verify the member's eligibility each and every time services are provided. The benefits of obtaining insurance verification prior to the patient's arrival include:
- Reduce claim denials due to invalid patient information
- Obtain prior authorizations
- Ensure faster registration and/or enable pre-registration
- Verify which medical services are covered/not covered
- Obtain information about the patient's co-pay, coinsurance, and deductible
We Provide Real-Time Benefits Verification
One of the most valuable tools for reducing claims processing time is benefit verification. Access to real-time benefits verification can save your staff from lengthy phone calls or being placed on long holds with insurance companies. In a busy office, the medical staff probably doesn't have enough time to call the insurance company anyway. You can save your office time and money by subscribing to a real-time benefits verification vendor. We at National Physicians Support and Billing, LLC, help offices limit the amount of denials received due to:
- Incorrect/Invalid subscriber number
- Missing/Invalid group number
- Coordination of Benefits information required
- Requires referral/prior authorization
- Not eligible on date of service
Types of Offices & Practices Benefitting from Our Full Practice Services
Allergy & Immunology
Neurology
Anesthesiology
Obstetrics & Gynecology
Chiropractic
Oncology (Cancer)
Cardiology
Ophthalmology
Dermatology
Orthopedics
Endocrinology, Diabetes, & Metabolism
Pathology
Family Practice
Pediatrics
Gastroenterology
Physical Medicine & Rehabilitation
General Practice
Plastic Surgery
Geriatrics
Podiatry
Infectious Disease
Preventive Medicine
Internal Medicine
Psychiatry
Medical Genetics
Radiology
Emergency Medicine
Otolaryngology
National Physicians Support & Billing, LLC, provides unbeatable medical billing at rates well below those of our competitors. We cater to the needs of our clients across the country, in such areas as Southfield, MI, Sherwood, OR, and Lake in the Hills, IL.
Insurance Payment Posting/Accounting
National Physicians Support & Billing, LLC, covers the receipt of explanation of benefits (EOBs) provided to the physician, who then pass along a photocopy to our service where we will then post each payment either using a line item posting method in our practice management software, or posting by claim.
Patient Payment Posting/Accounting: Applying any payments paid by the patient towards their account.
Follow-up of Insurance Claims: We simply run reports to determine which claims have not been paid for the purpose of calling the insurance carrier to determine the “status” of the claim. We then do whatever we need to do to get the claim paid. Here are a couple of common reasons why a claim has not been paid along with the action we would take to bring the claim to a paid status:
- Insurance carrier has no record of receipt of claim, in that case we will resubmit the claim
- Insurance carrier requires a progress report from the physician we will determine the reason why the insurance carrier needs the report (missing information, unclear information) and either request a report to be sent by the physician or make the necessary corrections if they are within our control.
Patients' Statements: Depending on what has been decided between National Physicians Support and the client. Patient statements are usually generated once a month, generally on the 15th or the 30th. Patients that have any outstanding balance to their account receive a statement indicating their balance owed. All copies of checks and statement sheets should be provided to our office.
Monthly Reports
Standard reporting would detail such things as:
- Monthly service totals
- Monthly payment totals
- Payments by insurance
- Payments by patient
- Monthly procedure utilization
- Practice analysis reporting
We also provide custom reports as requested by your clients for an additional fee.
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