BOSS’s Virtual Assistance service can spare two hours a day of your front end staffs work time, which can be utilized for other essential patient service. Virtual assistance is typical created to absorb the multi-faceted challenges faced by the client’s front office staffs on day today basis. Patient scheduling, insurance verification, maintaining patient appointments and answering patient’s questions on bills and payments and documentations are the fronts on which our solution team takes over the chunk of the client’s burden. With the outsourcing to us, the front desk person is left with the responsibility of overseeing of our team. With reduced flux at the front desk and the client finds time to build customer rapport which translates into threshold for achievement of enhanced doctor-patient relationship. Our Virtual Assistance solution covers the services listed herein.
Outsource patient appointment scheduling to BOSS
Proper management of the medical appointment scheduling process contributes to the betterment of a medical practice in terms of efficiency and economy. It is a fact that many medical practitioners have entered the medical profession not just for the satisfaction of bettering the health of a number of patients but because of the great monetary gains. Streamlining of the appointment scheduling process would ensure that the healthcare provider can spend more time with the patients, increasing patient satisfaction and revenue.
BOSS provided complete patient appointment scheduling and answering service.
- Calling patient and scheduling the next visit
- Answering patient about the availability of doctor and free slots
Advantages in outsourcing patient scheduling to BOSS
- Helps to ascertain the availability of the doctor, medical assistants, nurses, and other resources of the medical office
- Office personnel can easily find the earliest vacant scheduled time, in a day or week
- Recurring appointments can be easily scheduled
- Patients can be reminded, in sufficient advance, of upcoming appointments
- Makes easy appointment cancellation and rescheduling
- Makes it possible to track referring physicians and insurance coverage
- Fewer scheduling errors
- Reduces no-shows
Outsource eligibility & Benefits verification to BOSS
Itâ€™s mandate for the Doctor’s office and hospitals to verify the patient insurance coverage and benefits before rendering the service to the patients. This would avoid unnecessary denials and delay in payments from insurance carriers, unless otherwise the patient is a self pay, workman compensation or PIP. There is no exact statistics on the amount of $ lost by hospitals and doctors office due incorrect or no insurance verification done on patient coverage and benefits every year. Itâ€™s also leads to strained relation between office staffs and patient when followed up for bill payments and reminders. Proper eligibility and benefit verification is done is the first step for clean payments from insurance carrier and good patient relation.
Verifying patient coverage and benefits detail is always first step for a healthy revenue management. This would inform the patient of their responsibilities on covered and non covered services at the time of appointment scheduling. By doing this it is not only helps the patients to decide on the course of treatment and also the provider of reimbursement for their service rendered.
Outsourcing patient verification service to BOSS you can have assured Benefits:
- Healthy revenue cycle
- Reduces A/R days.
- Stream lined cash collections by reducing write-offs and denials.
- Unnecessary patient follow-ups, reminders and last minute appointment cancellations.
By verifying patient insurance eligibility and benefits you can void the following claim denials.
- No coverage : Policy either termed prior to date of service or policy coverage starts after the date of service, either way the insurance carrier do not pay the provider.
- Deductible not met: Here claims appear to be clean claim gets processed with no payment and rolled over to patentâ€™s responsibility. The patient would not have paid the said annual deductible amount by the insurance carrier for the insurance cover to the service or may have paid the partial amount of the deductible which may not cover the service. Another common error often goes un-noticed when verifying patient coverage for provider who is non-contracted with insurance carrier is out of network deductible not met by the patient? For patients under PPO/EPO/POS/ HMO options/ Indemnity plans they have out of network benefits options open. When verifying the benefits for out of network coverage most agents and patient quote that annual deductible is met but still the claim gets denied for payment. Actually when looking into the issue, is deductible met? YES and patient would also say refer the same that he/she has paid the annual deductible but technically NO. Front desk staffs often fail to understand that there are two diversified deductibles when comes to the above said plans, INNETWORK and OUT OF NETWORK deductible. When patient choose to see a non-contracted provider, patient has to satisfy the out of network deductible as well, so that insurance carrier covers the medical expenses incurred. This were the mistake happens, patients would strongly refer that he/she has met the deductible and front desk staff believe the same, actually here patient refers to the INNETWORK deductible that was met but not the OUT OF NEWORK deductible which they are not aware.
- Maximum Benefits Met: Insurance carrier would cover maximum service pertained either to number of visits or $dollar value. E.g. Insurance would cover 15 chiro manipulation visits and 20 physical therapy visits annually or would cover $2000.00 of both chiro and PT annually, any visit after that will not be a covered expense. It is always recommendable to check whether any of the visits used up before render the medical service.
- Non Covered Service: Not all procedures and medical expenses are covered by insurance carrier. As per patients plan insurance would determine whether or not a covered service. E.g. Medicare does not cover any x-rays, scans taken by chiro. Medicare’s chiropractic benefit will be determined by your medical need. Most insurance carrier does not cover cosmetic surgeries. Some patients plan only cover major medicals and no routine visits or follow-up visits are covered.
- Frequency: Certain procedure is covered only if it is done after/ within the defined period of interval. E.g. dental x-rays are covered only once in three months. Certain dental procedure should be done with certain time interval from previous service, e.g. root canal treatment, insertion of rod and crowning.
- No prior Authorization: As per patientâ€™s plan certain procedures requires a prior approval from insurance carrier and itâ€™s the providerâ€™s responsibility to obtain authorization on time. Before rendering the service the patient provider should make sure the procedure requires authorization or not from the insurance carrier. Even an office visit would get denied for no prior approval in certain patientâ€™s plan, when provider is non-contracted with insurance carrier.
With growing number of medical service providers and their allied service support are pushed to limits in keeping up the phase with constant rising questions from the patients. Most patient inquiries can be categorized as
- Seeking appointments and cancellations
- Bill payments and clarifications on bills received
- Asking medical documents and reports.
Most front end staffs can handle appointments and medical reports but handling patient queries on bills are quite complicate and need thorough knowledge on the particular account. BOSS patient answering team can handle all three at any given time; it reduces stress on the front office staff on hearing phone bell ringing and allows them to concentrate more on medical oriented service.
There many reason to say why patient receives bills from doctorâ€™s office. When patient visits the doctor, patient has to sign up the AOB (assignment of benefits is used, which an authorization directing the insurer to make payment directly to the provider of benefits, rather than to the insured; the insurance carrier however, is the one who determines whether benefits are payable) and other disclosure form at the doctorâ€™s office. These forms clear states incase if there is a denial or no payment from insurance patient will held responsible for the complete or the insurance said amount. Since most patients and the front end staffs have no knowledge on why the claim is denied or is any other way to resolve the account with insurance without paying from the pocket or it is the cost sharing method followed by insurance. BOSSâ€™s patient answering team comes with experience in taking up the all kind of billing related queries.
BOSS as complete knowledge on why the patient is being billed for genuine reasons:
- No coverage at the time of service: insurance policy would not effective at the time of service; either the policy would have termed prior to date of service or policy coverage starts after the date of service.
- Deductible not met: Patient would have not paid the insurance said annual deductible or partially paid.
- Maximum Benefits Met: Patient has used all the visit or $dollar reimbursement for the annual year.
- Service not covered: The performed service is not a covered service under the patientâ€™s plan.
- Co-insurance or cost sharing: Patient has no secondary coverage
- Primary paid more than the secondary allowed amount
- Pre existing condition