Save $118 Per Claim Through Efficient Eligibility Verification Solution

Patient Eligibility Denials

Claim denials are tiresome and tedious to rework. Claim reworks are expensive. On an average any healthcare organization expends 9% of their net revenue on reworks. One of the most common denials any Healthcare Organization(s) struggle to combat is Patient Eligibility denials.

Through the below listed infographic, find out precisely how much revenue you lose and find out how you can plug this loss. A detailed analysis depicting just how adverse the effect of patient eligibility denials are. The infograph also points out effective solutions through which you curtail these losses. The below content has been produced through analysis of reliable real time data and provides you with much needed information in easily digestible bites.

An average of $3 trillion in claims were submitted from Jan 2019 – Jan 2020. Of which an estimated $262 billion in claims were initially denied due to eligibility denials.

Understanding The True Impact Of Eligibility Denials

How to plug this revenue loss

The only way to plug this loss is by conclusively establishing the eligibility of the patient prior to services rendered. The most effective time to check for eligibility is during appointment scheduling. Integrate your current scheduling software/system with a tool/software that determines eligibility. You need to have the eligibility report days prior to the scheduled visit.

Two ways to incorporate the above solution

1. Create an in house tool that integrates with the scheduling software and payor networks and determines all criterias of eligibility.
2. Outsource your process to vendors, who provide you with a complete package. A scheduling software & a conclusive eligibility checker, that can integrate across payor networks and determine all criterias of eligibility.