Managing insurance claims in the healthcare industry is often as challenging as delivering top-notch care for your patients. Whether you’re running a lab or a pharmacy, the burdens of claim denials, coding errors, and long reimbursement delays might be all too familiar.
According to a survey by Experian Health, 70% of healthcare leaders stated that claims management is more important now and reduction of claim denials is a top priority. This is where eClaimStatus steps in to seamlessly manage complex claims, reducing your burden in the process and allowing you to focus on delivering exceptional patient care. Curious to know how eClaimStatus does that? Let’s dive in!
Challenges Faced by Healthcare Practitioners When Handling Insurance Claims
The relationship between insurance companies and healthcare practitioners plays a major role in determining the quality and timeliness of the medical care patients receive. However, that can be impacted by the intricate and challenging process of obtaining reimbursements for the services rendered. Coupled with evolving insurance policies, healthcare professionals have to face a myriad of obstacles in managing claims, some of which include:
Claim Rejections
This is a common hurdle faced by medical practitioners that disrupts revenue, increases administrative burdens, and complicates compliance with ever-changing insurance guidelines. A recently published Commonwealth Fund report indicated that 17% of insured respondents had their insurance claims rejected, and nearly six of ten adults faced treatment delays as a result.
Insurance companies often follow strict review procedures that may result in rejected claims even due to minor discrepancies. The appeal process following the denial will also be time-consuming and resource-intensive, which further impacts patient care.
Prior Authorization Requirements
For certain medical procedures, insurance companies mandate prior authorization, which typically involves extensive paperwork, communication, and follow-ups. Healthcare providers must gather detailed documentation, submit requests, and wait for approvals, which can take days or even weeks. Approval delays will only postpone critical patient treatments, impacting their health and even causing financial strain for the practice.
Delayed Payments
Delayed payments can severely disrupt a healthcare facility’s cash flow and financial stability. When claims are submitted, they go through extensive reviews and delays, in this case, can arise out of incomplete documentation, coding errors, inaccurate patient information, etc. Extended reimbursement timelines will also hinder operations, patient care, and investments in equipment and staff.
Lack of Transparency
Healthcare professionals often face transparency issues in the insurance process, which further complicates billing and reimbursement efforts. They are left in the dark regarding the status of their claims and in case of denials, they are not given clear reasons behind the rejections. The lack of real-time visibility into claim delays will only lead to financial uncertainties for healthcare practices, impacting the practices’ revenue cycle management and increasing frustration for patients as well.
Complex Billing Procedures
Complex billing procedures present a significant challenge in the healthcare industry. About $935 million is lost weekly in the US healthcare system due to billing errors, indicating the necessity for healthcare professionals to navigate the intricacies of medical coding while maintaining compliance with diverse insurance policies and regulations. Errors or discrepancies in coding can result in claim denials, which is why translating medical procedures into standardized codes is critical for claim approval.
The Role of eClaimStatus in Managing Complex Claims
With the mounting obstacles healthcare facilities face with managing insurance claims, eClaimStatus steps in as the solution to removing that administrative burden for you. We offer a better and faster way to retrieve claim status for efficient analysis and faster reimbursements, where you also reduce your costs around its verification by nearly 60%. We help you achieve this by:
- Fetching claim status in seconds
- Verifying Medicare and Medicaid Eligibility
- Verifying patient insurance eligibility and benefits from over 900 companies. Our platform helps you with root cause analysis and prevention of future denials, also enabling you to shift your focus to more profitable tasks.
And in the subject of managing health insurance claims, eClaimStatus offers you the following benefits:
- Single login: To verify the claim status of your patients, you don’t have to keep calling, faxing, or following up with insurance companies. All you need is a username and password. With a single login, you can view the real-time claim status of your patients in 3-5 seconds with additional details like adjudication date, payment details, reasons for denial, etc.
- Bulk Claim Status: With our platform, claim status checks take only a few seconds and up to 1-2 minutes for over a 1000 records. No matter the number of claims, you can check multiple patient claims using Batch Mode in eClaimStatus and get the complete report in just a single click.
- Zero Installation and maintenance: Our web-based solution can be accessed anytime, anywhere through your desktop or laptop, eliminating the need for installation or incurring any maintenance costs. We also keep our software up-to-date with all changes in insurance policies and regulations.
- Security and safety: eClaimStatus is SSAE-16 SOC-1, SOC-2 certified and we’re also compliant with HIPAA HITECH, PCI-Level 1 DSS, and NIST 800-53 standards, ensuring maximum safety and security of your practice and patient data.
- Cost-efficiency and higher revenue: We offer monthly subscription plans with no lock-in periods or long-term contracts, making it more budget-friendly. Our system also alerts you of denied claims and the causes of it, allowing you to take immediate action and resolve, which will help maximize your practice’s revenue.
- Customer support team: If you face any difficulties with our platform, you can raise your concerns through our support ticket system. Once we receive your ticket, our support team will solve your issues on priority via email, phone, or remote screen sharing tools.
Simplify Claims Processing and Manage Your Revenue Cycle with eClaimStatus
Managing complex insurance claims doesn’t have to be stressful anymore. With eClaimStatus, you streamline every step, from submission to reimbursements. With our platform’s automation capabilities and real-time visibility features, you can instantly check claim status and avoid committing any manual documentation or coding errors that will end up in costly delays or denials. While we handle claims management, you can focus on growing your business and delivering exceptional care to your patients. Sign up for our 15-day free trial to know more about our services!
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
