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4 strategies for effective document verification process in hospitals

Healthcare revenue cycle management demands extensive insurance eligibility verification processes.  When it comes to insurance management for the healthcare industry, the verification of documents such as the likes of insurance cards is a very basic step. However, at the same time, it is of great critical importance as well. This document verification process is what paves the way for accurate claim submissions and timely reimbursements to patients or insurance companies.

While the correlation between insurance management and healthcare processes is well known, most do not understand the true scale of the importance of the connection. So, why is this process so critical, and how can healthcare businesses optimize the document verification process for maximum efficiency?

The High Cost of Errors And Why Document Verification Matters

As of 2022, about 92.1% people in the United States had health insurance. This 92.1% translates roughly to 304 million. These are huge numbers of people who visit healthcare professionals and have chosen to pay with insurance in case the need arises. Now, if a patient visits a medical facility that is covered by their insurance provider, the patient will not feel mentally burdened, assuming their insurance covers the treatment. However, what if due to an oversight in the document verification process, the insurance company denies the claim? What will happen then?

This will inevitably lead to the patient suffering either financially or medically if they cannot pay their bills on their own. Even if the issues are solved later, it will still lead to delays in reimbursement for the healthcare provider. Thus, effective document verification process is essential for trust between patients, healthcare services, and insurance providers.

Statistics and data paint a very clear picture of the impact that errors in insurance verification have. According to research by Experian, roughly 5-15% of all healthcare insurance claims are denied.  Denials here represent lost money, delays in reimbursements, and overheard costs, etc. Problems with the document verification process frequently lead to patients suffering.

While patients suffer in at least two of these ways in all cases – mentally, financially, and medically – the healthcare services face problems too. These problems relate to significant financial losses for healthcare providers, with average accounts receivable days potentially increasing by 30% when verification is inadequate. These figures emphasize the immense importance of a robust document verification process in securing financial stability.

Key Strategies To Building a Streamlined System To Verify Documents Online

Fortunately, to counter these healthcare and insurance issues, we have the document verification solution to the rescue. Healthcare providers can implement different types of strategies to verify documents of identity efficiently and minimize errors.

Multi-Channel Approach

Businesses can step up a multi-pronged approach to the document verification process. For example, instead of limiting themselves to a single system, service providers can set up a combination of different ones. These can include phone calls, Interactive Voice Response (IVR) systems, and even secure online portals. A portal for the document verification process can be set up by the business itself or can be accessed via a third-party identity document verification service. These service providers can also help users and teach them how to verify documents effectively.

Data Accuracy

Data accuracy is the foundation of success for any business that has to deal with a large influx of data. The document verification process hinges on accurate patient information.

Businesses must invest in thorough data collection and regularly update patient demographics as well as insurance details. Consistent and regular audits of patient records help to ensure the accuracy and completeness of this vital data. This is critical for the prevention of claim denials.

Proactive Issue Resolution

While they can financially exhaust businesses, it is essential to not let roadblocks stall the document verification process. Rapid identification and attention to discrepancies or missing information during document verification process is critical. This proactive intervention can help ensure a smooth claims processing flow. Furthermore, it greatly minimizes the chances of denials later.

Invest in Staff Expertise

The document verification process involves the navigation of complex insurance policies and procedures. Since human employees manage a big chunk of this management and verification process, it is essential to invest in stall trainings. Continuous training for all the staff involved in the verification process is essential to them updated on the latest trends and changes in insurance regulations, coding guidelines, and best practices. A well-trained team of employees can better handle the intricacies of the document verification process and reduce errors.

In conclusion,  

By optimizing the insurance eligibility document verification, healthcare providers can lay a strong foundation for financial stability. The implementation of advanced strategies coupled with the benefits of outsourcing to trusted partners can lead to a streamlined claims processing system. Furthermore, it can reduce claim denials, and thereby, ultimately, improve revenue generation.

Healthcare businesses must pay attention to the insurance management process. By taking stronger control we can ensure a smoother path to financial success.

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