Urgent Care as the name specifies are healthcare services that require immediate care for the patient. Urgent Care clinics/ facilities act as a bridge between the primary care physicians and emergency rooms. In short, the life of staff’s working in an Urgent Care clinic/ facility is fast phased and buzzes with activities.
Due to the walk-in-nature of the appointments, Urgent Care clinics/facilities do not have an appointment scheduling process. Even in situations like the Urgent Care the patient demographic details are to be collected that serves as key to the creation of claim and submission to the insurance companies for reimbursements. It is very important that the registration team is able to capture the required details at the time of patient admission.
Failure to collect information at the time of rendering service could have occurred due to multiple reasons, such as
- Patient forgets to get the insurance card for registration process
- Patient does not remember the correct insurance ID number
- When the patient is not aware of other active coverage that they may have
- Due to the nature of the visit the patient may not be in a situation to provide the insurance demographic details
- Due to system downtime
These factors could have a ripple effect on the claim reimbursement. Without determining the correct payor, the claim will not be processed accurately thereby resulting in the charges getting stagnant in the Account Receivables as unresolved or end up in the patient bucket which eventually end up in collections as uncollectable.
Even if the information details are got there can be scenarios wherein the policy could have lapsed. The patient may have multiple insurances and the CBO (Centralized Billing Office) may be unsure of the COB (Co-ordination Of Benefits) sequence to file the claims thereby delaying the reimbursement process for the claim.
The Insurance Discovery software that is a combination of advanced AI (Artificial Intelligence) technology and expertise from healthcare veterans provides the perfect solution for such scenarios. The tool is built around 15 algorithms with AI (Artificial Intelligence) that has the capability to retrieve the patient’s insurance demographic information and update the algorithm as per output received from the payers. The tool will retrieve the insurance demographic details by providing a few patient demographic details.
The insurance information retrieved using the Insurance Discovery tool is precise and provides the current active insurances available for the patient. The Insurance Discovery tool goes a step further and has the capability to provide the COB (Co-ordination Of Benefit) information making it easier for CBO (Centralized Billing Office) to file the claims to the correct responsible insurance payor.
Using Insurance Discovery tool provides faster reimbursement of claims by identifying the correct responsible payors. The tool enables staff in the Urgent Care clinic/ facility to focus on rendering care to the patients. The Urgent Care clinic/ facility has their own share of benefits by reducing the cost of hiring multiple staff to manage the patient traffic and doing the insurance verification work
Leave your insurance eligibility verification to eClaimStatus. Get started with your 15-day free trial, call us at 310-294-9242 or write to us sales@eclaimstatus.com
