Free Claims Revenue Checkup

Claims Revenue Checkup – Eligibility Verification


As a highly sagacious new-age medical billing company BillingParadise's primary goal has always been to better a clinic's bottom-line, and in this respect the think-tank at BillingParadise have regularly been coming up with innovative service offerings to its huge existing and prospective customer base.

To this end, as a subset of the free comprehensive annual checkup that BillingParadise is offering all prospective clinics, it will now also perform a smaller claims revenue checkup, in accordance with the latest AMA standards

Eligibility Verification

This is where the buck starts in a claims revenue cycle. As of January 1, 2013 health insurers are mandated to send solid eligibility information to physician clinics in regards to a patient's eligibility including details on patient's copay responsibilities. This would constitute more than just a simple "yes" or "no" and give physicians information on detailed patient eligibility.

Cost Savings in Electronic Eligibility Verification

AMA estimates that nearly $4000 per physician per year can be saved by using the electronic means to patient eligibility verification as opposed to the manual route. This estimate may seem apparent when you watch your staff spend hours on the hour with insurers checking eligibility criteria for patients and filling out voluminous forms, either online or paper-based.

AMA had arrived at the figure using the below cost savings calculator:

Cost of paper Eligibility Verification: $3.70 x 1,250 :: $4,625

Cost of Electronic Eligibility Verification:: $0.74 x 1,250::$0,925

Average Annual Savings from Electronic Eligibility Verification per Physician:::$3,700

Where "1,250" is the average claims verifications done for a single physician per year. You may substitute this with your clinic's actual numbers to arrive at the cost savings for you.

When are you supposed to meet Mr. Smith?

We know! We offer appointment scheduling services that will make missed appointments a distant memory.

Our team also sends regular appointment reminders. Our quick and super efficient electronic claims transmission process will help your claims reach the insurer's doorstep quicker than ever.

Kareo Can Enable This Cost Savings For You

Kareo increases your billing collections by discarding uncollectable revenue from patients with invalid insurance benefits. You can receive an insurance eligbility report in less than 30 seconds, which can be viewed either online, printed, or saved to the patient's medical records in the PracticeFusion EMR to be utilized any time.

This instantaneous insight can help you determine beforehand what you are up against when dealing with a particular patient and thus determine with foresight rather than hindsight the patient's copay, coinsurance, and deductible. This is going to save considerable amount of your staff's time later on in the form of not having to deal with denied claims. This is the primary mechanism (optimal usage of staff time and thus your resources for which you incur considerable expenses) by which you realize the above savings.

The Electronic Mechanism

The standard via which this is accomplished in Kareo or any other practice management software (in which BillingParadise has considerable experience) is the ANSI 270/271, commonly referred to as the "Insurance Eligibility Benefit Inquiry and Response".

All you would need to perform this is the following:

Patient Details.

Insurance policy information such as name and number.

Provider's tax ID and NPI number.

With just the above data insurance eligibility can be submitted via Kareo to a multitude of federal and commercial insurances in every state.

BillingParadise, working as a certified consultant for the PracticeFusion-Kareo duo is ideally placed to bring to fruition the above savings in the Patient Eligibility Process. What more, since we offer PracticeFusion-Kareo free of cost, you will be in a unique position to enjoy all of the above savings.

Call us, BillingParadise at 1-888-571-9069 or email , so that we can help you take this first step in positively impacting your clinic's bottom line.