How to Increase Revenue with Automated Insurance Eligibility

Updated April 14, 2023, by Blakely Roth

Patient billing is a pain point for many medical practices. Practices know the importance of providing patients with an excellent experience from start to finish.

But without the proper flow of revenue, it becomes difficult to maintain a high level of patient care. By automating insurance eligibility checks, your practice can have the best of both worlds.

The Insurance Eligibility Challenge

Many practices lack the capability of providing cost information upfront to patients. They interact with several payees before they get paid in full for services.

The popularity of high deductible plans combined with the intricacies of how to pay for payer claims reimbursement makes things complicated. Practices must reach out to different points of contact to receive part of a payment. Such challenges complicate revenue cycle management.

Almost all medical practices face:

Billing and collection errors

Often, billing and collection errors are due to oversights during manual input. Inaccurate billing results in medical practices losing out on revenue. It can also burden patients with debts.

Claim rejections

If your practice doesn’t monitor the claims process, it becomes difficult to pinpoint errors that lead to claim denials by insurance providers. One checkpoint that is particularly easy to overlook is running the appropriate and real-time insurance eligibility checks.

The Proven Insurance Eligibility Solution

For practices to achieve long-term revenue cycle management, they need to be able to collect patient financial responsibility up front. Many patients have high-deductible health plans.

For providers, that means they depend more on their patients to shoulder the cost of healthcare services. Despite footing more healthcare bills, a TransUnion Healthcare analysis shows that over 2/3 of patients can’t cover their entire medical bill.

Underpaid financial responsibility slows a practice’s revenue cycles. Practices run the risk of never recovering the full payment. Staff uses extra resources to get in touch with the patients and collect payments.

Checking eligibility and authenticating coverage are routine but tedious aspects of your billing workflow. The process can be made easier when Clearwave automates your billing workflow.

Clearwave’s insurance eligibility software seamlessly integrates with more than 50 of the most popular EHR/EMR and patient management systems including Compulink, AdvancedMD, Epic, NextGen, and many more! This integration provides real-time benefits and eligibility verification.

Real-time results speed up payment velocity. Your patients get financial transparency at the time of scheduling. This allows them to access any necessary details needed to arrange their payment options, helping to avoid follow-ups and misunderstandings. Most importantly, it makes sure your practice gets reimbursed!

This highly customizable solution allows your practice to implement Clearwave according to your specific needs, including insurance eligibility. Using the Enterprise Eligibility-as-a-Service engine reduces the training burden and workload of your staff by up to 65 percent.

You can leverage Clearwave to automate the transmission of NOAs (Notice of Admissions) to improve timely claims processing, reduce denials and lower payment penalties. Other benefits and capabilities of Clearwave include:

● Central storage of payment records and billing information for better tracking of your patients’ billable services
● Accounts receivable and payer’s functionality to keep tabs on current balances
● Automated reminders for patients’ balance payments

Maximize Your Revenue

Clearwave’s insurance eligibility software automatically runs real-time patient eligibility without staff involvement. Clearwave enables your practice to access the data you need immediately to make sound decisions about patient payment.

Ready to find out how Clearwave can help your practice maximize its revenue? Request your quick 30-minute demo with Clearwave today!