Processing health insurance claims of patients in an efficient manner positively impacts your hospital revenue cycle management. Think of it this way: The more insured patients you treat, the greater your revenue rises. Given this, it’s essential that your RCM focuses on determining and verifying insurance eligibility, which is part of the initial phase of every transaction. Determining patients’ eligibility for Medicaid and other health insurance programs takes time and requires a set of skills and knowledge. The staff performing this job should be well aware of all aspects of Medicaid enrollment, a daunting task to say the least. This is why many hospitals struggle with this area of their RCM. If this is the case for you, then you may want to start seeking third-party help to deal with all Medicaid eligibility requirements. Doing so reaps many benefits, especially if your workforce is too light for such a job.
Boosts Staff Productivity Hiring eligibility experts means that hospital staff will no longer be responsible for dealing with self-pay patients. It can, therefore, focus on more important tasks and will be able to allocate its skills to objectives specific to its expertise. This, in turn, will improve productivity and minimize otherwise unproductive time spent learning the ins and outs of various programs or policies. Better productivity results in a more efficient operation of your hospital. Avoids Wasting Time and Resources Eligibility specialists are trained in this specific task, meaning hospitals don’t have to be responsible for setting up a curriculum or a facilitation for training staff–another departure from the main business of operating the hospital. You won’t have to spend time and resources making sure that patients are covered with insurance, because the experts have it under control. Your operation will get paid while making sure that time and resources are used wisely. Minimizes Expenses Usually, you will only have to pay eligibility experts once the hospital has collected payments. This means that you won’t have to settle up-front costs, allowing you to more easily manage your finances. These are only some of the benefits your hospital reaps when it calls for help in determining whether patients are eligible for Medicaid. There are companies that offer RCM improvement services; all you have to do is give them a call to understand how the partnership works. Sources: Why outsource? Enhance the revenue cycle with third-party eligibility and enrollment specialists, healthcarefinancenews.com Determining Eligibility for Medicaid, medicaid.gov