Collecting Wisely: Reducing Errors & Accelerating Reimbursements in Healthcare

By Chloe From Clearwave | August 5, 2024

Efficient revenue cycle management is crucial for practice success. As Medicaid/Medicare reimbursements continue to drop along with patient propensity to pay, practices need innovative solutions to streamline collections, reduce claim rejections and accelerate reimbursements. See how Multi-Factor Eligibility™ verification can transform your practice’s financial performance and patient experience.

The Power of Multi-Factor Eligibility

Multi-Factor Eligibility verification is a game-changing approach that goes beyond traditional insurance verification methods. By leveraging advanced technology and multiple data sources, this tool provides a comprehensive and real-time view of patient insurance information, enabling practices to:

• Reduce claim rejections
• Increase point-of-service collections
• Save staff time
• Improve patient satisfaction

Let’s dive deeper into four ways Multi-Factor Eligibility can revolutionize your practice’s revenue cycle management.

1. Reducing Claim Rejections

When it comes to collections and reimbursement, one of the biggest challenges practices face is a high rate of claim rejections due to inaccurate or outdated insurance information. Multi-Factor Eligibility tackles this issue head-on by:

1. Performing multiple eligibility checks throughout the patient journey
2. Speeding up staff review of eligibility verification 
3. Enabling fast and automatic resubmission of errored transactions

By running eligibility checks an average of seven times per patient engagement, practices can catch and correct insurance errors before they impact claim submissions. This proactive approach has led to a remarkable 100% drop in claim rejections for practices utilizing Multi-Factor Eligibility. 

The reduction in claim rejections not only improves cash flow but also significantly reduces the administrative burden on billing staff. Furthermore, this increased efficiency allows practices to allocate more resources to patient care and practice growth initiatives, ultimately leading to improved overall performance and patient satisfaction.

2. Streamlining Staff Workflows

Multi-Factor Eligibility verification dramatically reduces the time and effort required for insurance verification, allowing practices to reallocate resources to other critical areas.

The software provides a centralized dashboard that offers a comprehensive overview of patient coverage details. This user-friendly interface allows staff to quickly identify insurance discrepancies, access individual patient information with a single click, and focus solely on cases requiring attention. By streamlining these processes, practices have reported a 2x reduction in eligibility verification workloads.

Another time-saving feature is the system’s ability to automatically map payers to appointment types. This intelligent functionality matches and inputs the correct co-pay amount to patient accounts without staff involvement, reducing manual errors and the need for future adjustments. By streamlining this process, healthcare providers can significantly improve their revenue cycle management and reduce administrative burden. Additionally, this automation allows front desk staff to focus more on patient care and experience, rather than getting bogged down in financial details.

3. Boosting Point-of-Service Collections

Collecting patient payments at the time of service is crucial for maintaining a healthy cash flow. Multi-Factor Eligibility empowers practices to present accurate co-pay information at every patient check-in, leading to a substantial 112% increase in point-of-service collections.

By verifying insurance at every critical patient interaction, the system ensures that coverage information is always up-to-date. This real-time approach allows practices to:

• Confirm active coverage before rendering services
• Present the most accurate co-pay amount to patients during registration
• Reduce the need for post-service billing and collection efforts

Accurate eligibility verification not only increases collections but also minimizes the challenges associated with over- or under-collecting at check-in. This precision helps practices avoid the administrative burden of processing refunds or chasing down additional payments after the fact.

4. Addressing Self-Pay and Medicaid Patients

Self-pay patients and those with Medicare and Medicaid coverage often present unique collection challenges for practices. Multi-Factor Eligibility offers innovative solutions to speed up identification of these patients in order to ensure timely collections and boost reimbursement.

The software enables practices to check self-pay patients against Medicaid and Medicare in real-time or in monthly batches. This feature helps identify patients who may have recently become eligible for Medicaid coverage, ensuring that practices can bill appropriately and maximize reimbursement opportunities. Additionally, Multi-Factor Eligibility allows practices to set up custom self-pay rules, enabling the collection of desired self-pay amounts at patient check-in. This automated approach simplifies the self-pay collection process and helps practices maintain consistent financial policies.

The Future of Revenue Cycle Management

As healthcare continues to evolve, practices must adapt to new challenges and opportunities in revenue cycle management. Clearwave’s Multi-Factor Eligibility verification represents a significant leap forward in this domain, offering a powerful suite of tools to reduce errors, accelerate reimbursements, and improve overall financial performance.

As we look to the future, it’s clear that Multi-Factor Eligibility will play an increasingly important role in helping practices navigate the complex landscape of healthcare reimbursement. By collecting wisely and leveraging advanced technology, practices can position themselves for long-term success in an ever-changing industry.

See how one practice was able to reduce claim rejections, caused by data errors, by 100%! Read their story and see how you can take a similar approach, even with lean staffing numbers.