Setting up right expectations with allowable reimbursements
Figuring out the benefits and coverage that a patient is entitled to for particular medical procedures is one of the most important steps.
It gives you a better understanding of the allowable reimbursements that have to be collected from either the patient or the insurances. In a climate where patients have high deductibles, it is important to set up the right expectations from your patient.
Patient doctor relations must not be hampered
Verifying the benefits will tell you whether the services you provide fall under your patient’s insurance plan. So, if your patient has a low premium plan, then their insurance is likely to cover fewer medical services.
I have been a very satisfied client with Practolytics for nearly 5 years now. As you would expect, they are collecting the money that we have worked so hard for. We like the fact that they share our passion for data. We both approach our common issue i.e., how to collect money from a data centric viewpoint, and this drives improvement. The team is always willing to listen to us and make changes if necessary. Through the years we have asked for help with various office activities from credentialing to prior authorizations to procurement of outside medical records. Yes, these were add on-services, but outsourcing these activities to their team has been a winning solution that has intertwined the billing team into the success of our practice. These add ons have been a good value for us too. Lastly, we have easy access to one of the principal partners on the billing team, and the response time has always been excellent. Thank you! Practolytics!
Three years ago I started a dermatology practice. Six month into my start up I had received approximately $15,000 and I had $115,000 in my accounts receivables. I had put my wife’s and my entire savings and every penny we had into this practice, not forgetting to mention, our hearts and souls. We were three weeks from not making payroll when Practolytics contacted us.
We are a solo orthopedic practice in North Carolina and our relationship with Practolytics started in June 2015. They have staff members who are always willing to help. They work very hard to make us happy and I appreciate all that they do on a daily basis. They take out the worry of getting payments and always follow up with insurance companies. I found the customer service to be unsurpassed. All phone calls are returned and our questions are answered in a thorough and timely manner. The monthly reports are easy to read and provide a quick assessment of the health of the practice, including the company’s account receivables. When I need advice or am unsure of something, it gives me comfort to know that they are just a phone call away. Switching to Practolytics was truly one of the best decisions that I have made for our practice. I truly look forward to a longtime relationship with the staff at Practolytics.
We have had horrible experiences with billing companies until we moved to Practolytics. Practolytics handled a very tough transition swiftly and without missing a beat and we were up and billing again in 3 weeks. The staff have always been super accommodating and responsive to queries and requirements. Sometimes the craziest questions have been answered in an extraordinary way. They have always executed the processes with swiftness and precision. With Practolytics as our billing partner, our revenue has improved significantly.
FAQs about Eligibility and Benefits Verification
How will Practolytics help us in the eligibility process?
We take the appointments from the scheduler 3 days in advance and will provide you the benefit details via email and also the notes will be posted to the PM/EMR system which practice can access.
What if we have add-on patients on the day before or same day of the appointment?
We assist practices on-add on patients within few hours from the time the patient gets added in the scheduler.
What happens when a patient's policy is inactive or their plan doesn’t cover certain services?
Practice will be alerted on these issues few days in advance so that they can contact the patients and make necessary arrangements.
Will we be provided any tool to run eligibility at our end?
The partnered PM/EMR system has real-time eligibility capability and practice will be provided access to this where they can run eligibility within a few seconds.
Do you provide the Eligibility & Benefits by the CPT code?
Yes, we do provide the Eligibility by CPT code, for eg: in Behavioral health we provide the benefits for evaluation, therapy services and TMS services by CPT codes.