Key Advantages:
- Efficiency
Reduces time spent on manual insurance verification processes, leading to faster intake processes, client check-ins, and improved workflow. - Accuracy
Minimizes errors associated with manual data entry and outdated information, ensuring patients and providers can access the most current insurance details. - Financial Transparency
Provides immediate insights into the patient’s financial responsibility and reduces unexpected charges.
- Enhanced Patient Experience
Streamlines the administrative process, reducing wait times and improving overall patient satisfaction with the treatment experience.
The PIMSY Advantage
PIMSY’s RTE integrates with the insurance verification clearinghouse, providing instant access to a patient’s insurance coverage information.
- Real-time insurance coverage verification and additional details (i.e., active coverage status, covered benefits, co-pays, deductibles, limitations, or exclusions).
- Automatic update of eligibility information to the medical record.
- Immediate view of eligibility details to ensure the accuracy of the visit information.
- Transparency in communicating details and financial expectations around insurance coverage, including possible co-pays or out-of-pocket expenses, allows patients to make informed decisions about their care.
FAQ
Q. How does real-time eligibility benefit my agency?
A. RTE streamlines the insurance verification process, reducing administrative workload, minimizing errors, improving workflow efficiency, and enhancing revenue cycle management through quicker and more accurate billing and patient collections.
Q. How does real-time eligibility improve patient experience?
A. It provides immediate and transparent information about the patient’s insurance coverage and financial responsibility, reducing wait times, confusion, and the likelihood of unexpected costs. This leads to better-informed decision-making and overall satisfaction.
Q. Can real-time eligibility checks be performed for all types of insurance plans?
A. RTE can be performed for many types of insurance plans, but the availability and extent of information may vary depending on the insurance provider’s system capabilities and the agreements with the mental healthcare provider.
Q. How secure is real-time eligibility?
A. RTE uses secure electronic data interchange (EDI) protocols to ensure patient and insurance information is transmitted securely and complies with regulatory standards such as HIPAA (Health Insurance Portability and Accountability Act).
Q. How do real-time eligibility checks affect the billing process?
A. RTE checks reduce the likelihood of claim denials and delays by verifying insurance coverage upfront, leading to more accurate and timely billing. This helps improve the overall revenue cycle management for mental healthcare providers.
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