If your front desk is doing verifications, you are not optimizing your revenue potential
Verification of benefits is just a part of the whole insurance revenue cycle management process. There are so many things to worry about when your clinic takes insurance.
Clinics are used to outsourcing all parts of their billing; credentialing, claims submissions, A/R, appeals etc. to a third party billing company but historically clinics have had their front desk verify benefits.
So if all insurance related items are generally outsourced, why is verification of benefits still being done in house? Possible reasons:
- Outsourced/third party billers don’t do verification of benefits
- The front desk can pull benefits using portals like Availity to check benefits
- The front desk can call the payer and ask them all the questions they want
Why should clinics outsource verification of benefits?
- Your front desk’s time is better spent filling free spots and booking patients
Although the front desk can use portals or call payers to pull benefits, but they only have 8 hours a day to help you run all the front office of your practice. Do you really want them to spent 2+ hours a day calling insurance companies? Wouldn’t it be better if they helped fill your schedule? Would you rather your front desk book 2 new appointments for you this week or call Blue Shield?
On average, the front desk spends 15 hours on eligibility. By outsourcing eligibility, the front desk gets 15 hours back to convert leads to patients and fill empty slots so you are fully booked which will directly impact your top line.
- Verification of benefits is more than using Availity
Using portals to pull benefits is only part of the verification process. Learning how to read a benefits report, interpret it, summarize it and explain it to the patients in simple, plain terms is the bulk of the work. While your front desk can absolutely do this, it is extremely time consuming to become well versed in eligibility and their time is better spent helping you run your practice.
- The cost of inaccurate verifications is massive
Some doctors and clinics underestimate the importance of eligibility. Did you know that the number one reason claims are denied are due to preventable eligibility errors? Billers know how important eligibility is, its usually the difference between a claim paid and a claim denied. It’s best to outsource eligibility to an expert in the same way to outsource billing to a medical biller.
- Your revenue is not maximized
One thing that some providers think when they are presented with the opportunity to outsource verifications: “But I have my front desk do my verifications so it’s free. Why would I pay to have someone to do it? That would be an added cost.”
This is the wrong way to think about it. Nothing is free. Let’s say your front desk spends 15 hours on verifications for purposes of this example. That would be 15 hours that she is not spending filling your schedule. Lets assume she can book an additional 2 patients per week. That’s an increase in revenue for you. Would you rather have her spend her time booking you 2 patients who might bring in $400 per patient instead of having her call insurance companies?
By outsourcing verifications, your front desk can focus on filling empty slots and getting more patients in the door.
- Keeping verifications in-house is not cost effective
One Body charges a flat fee per verification. This is a predictable cost. If your front desk does verifications, you have to look at what you pay her hourly and then calculate how long she is spending on eligibility. For each verification, how long is she spending. Lets take an example. Let’s say you have an initial evaluation with a reimbursement of $130 and a copay of $25. It takes your front desk 2 hours to verify this patient. At an hourly rate of $25/hour, that’s $50. You also have to pay your biller 5% of the reimbursement. Out of the $155, assuming that you actually get the reimbursement, you’d make less than $100. Your expense for the verification was $50 which is a 50% cost!
If you are interested in learning more about how One Body can help you with verifications, please email hello@onebodywellness.com