Insurance Discovery software from eClaimStatus is a unique creation of combining Artificial Intelligence along with human intelligence from years of end-to-end revenue cycle experts. The tool provides value add at multiple stages of the revenue cycle management process. Starting from the front office registration process until identifying existing insurances for the self-pay patients the tool simplifies and enhances the effectiveness of the staff.
Usually, the patient access team primary responsibilities are Appointments and scheduling, Patient Registration, preparing a EHR containing the patient demographic details, preparing a EHR of the patient containing the insurance demographic details, verification of patient insurance eligibility and insurance coverage, along with the benefits covered under the patient’s active insurance plan, preparation of medical records, collecting posting the Co-pay from the patient into the PMS tool. The Insurance Discovery tool helps in increasing the efficiency of the patient access eliminating the 2-time consuming process which is collecting/ verification of the patient insurance demographics and benefits.
The patient access team can use the Insurance Discovery tool to help reducing the claim rejections from the payers for incorrect/ invalid/ missing insurance demographic details. This reduction of claim rejects increases in the probability of the claims being sent to the insurance companies with minimum lag days providing a faster resolution of the claim and keeping the AR days under control. During the registration process, the insurance discovery tool can be utilized to validate/ retrieve the insurance coverage details, thereby providing accurate insurance demographics for claims filing and faster reimbursements.
The tool helps us in identifying the insurance coverage details of the patient for a particular date of service. The tool is designed to search and retrieve insurance data of the patient with a few mandatory patient demographic details.
The Account Receivables team can utilize the Insurance Discovery tool to resolve denials pertaining to coverage and Co-ordination Of Benefits (COB) at a much faster rate thereby increasing the efficiency of the ream. Utilizing the Insurance Discovery tool from the registration process can reduce the coverage related rejections and denials to a miniscule volume, thereby creating operational capacity to focus on other pending collectable claims.
Driven by Artificial intelligence and machine learning helps the tool to recognise the payer response, analyse patterns and update algorithms for more precise search results.
Additionally, the insurance discovery tool can be utilized in specialities such as Hospitals, Clinical Laboratory, Radiology, Anaesthesiology, Emergency where face to face interaction with the patient may or may-not be feasible.
The tool can be used by Charitable organizations to validate the financial status of the patients below poverty line to for any waivers to be considered.
To conclude the Insurance Discovery software empowers the various departments/ teams within the Revenue Cycle Management process by providing apt accurate insurance demographic data for the patient on a particular Date of Service (DOS). The precise information retrieved by the Insurance Discovery software helps in faster submission, correction of claims thereby reducing the lag days, lower AR days, faster reimbursement timelines increasing the efficiency of the COB.
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
