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.
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.
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