As per federal government law the patient may not be refused healthcare services for emergency situations even if they do not have insurance coverage details. Patients register themselves as self-pay even when they do have an active healthcare insurance due to many factors such as When the patient is unaware of the plan coverage and…
The insurance discovery tool is a unique software created by combined expert Revenue Cycle Healthcare professionals along with state of art Artificial Intelligence. There are 15 algorithms used to discover the current accurate payer for the patient. This helps in extending retrieving capabilities to Medicare, Medicaid, Commercial and private payors. The software has the ability…
The Insurance Discovery software is a blend of knowledge from the medical billing industry veterans and state of art Artificial Intelligence technology. The combination spans about 15 algorithms that help in the search and retrieval of accurate insurance demographic for a particular Date Of Service. The tool has the ability to provide the effective date…
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…
The patient access team is crucial they are considered “Face of the Practice” as they are the first point of contact with patient before seeing the provider for healthcare services. Patient access team is responsible for following activities: Appointments and scheduling, Patient Registration Collecting patient demographic details Collecting insurance details Checking patient insurance eligibility and…
The healthcare environment is increasingly becoming more complex. Physician clinics and hospitals constantly need to validate patients' insurance coverage, validity, benefits, exclusions, co-payments, and more. Medical insurance verification is one of the most crucial steps in the medical billing and coding process. Many progressive organizations understand the criticality of the medical insurance verification process and…
Patient Demographic is the information provided by the patient to the hospitals or medical centers. Physicians' clinics and hospitals must be extra vigilant in capturing the patient demographics. The vital information works as the core in the medical field, especially for health insurance claims. The patient demographics data comprises patient-specific information like Name, Age, Gender,…
Medicare is Federal Health Insurance program of the United States of America. Medicare began in 1965 under the Social Security Administration (SSA) and now been administered by the Centers for Medicare and Medicaid Services (CMS). Medicare aims to provide health insurance not only for Americans aged 65 and older but also to some younger people…
When insurer processes medical claims, there is an onus on them to determine the financial liability. A thorough process begins that checks every detail of the submitted claim and that sometimes results in claim denials. Now claim denials can sound very abstract unless there is a way to specify precise denial reasons. Medical claims have…
The principal challenge that most medical care providers face while claiming reimbursements is the chance of claim rejection and denial by payers. This not only results in financial loss for the hospitals or medical facilities but has the potential to strain their relations with the patients. Repetition of all the work for re-submission of the…