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Enhanced Clean Claims Rate (CCR)
Our detailed verification system, accurate data entry, and clear communication with patients and insurance companies all work together to minimize claim denials, speed up reimbursements, and improve your revenue cycle.
helps with
- Minimizing claim denials
- Speeding up reimbursements
- Improving revenue cycle efficiency
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Real-time Data Entry and Verification
Our team connects with insurance companies through phone calls and portals to cross-check information. This ensures informed decision-making and a streamlined eligibility verification process.
helps with
- Informed decision-making
- Streamlined eligibility verification
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Proactive Contact with Patients
Synova improves eligibility verification accuracy and efficiency by contacting patients directly. This allows for data-driven treatment plan decisions, optimizes billing, and minimizes potential reimbursement issues.
helps with
- Data-driven treatment plan decisions
- Optimizing billing
- Minimizing reimbursement issues
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Routine Follow-up with Insurance Carriers
Our eligibility verification specialists routinely follow up with insurance carriers to ensure accurate and up-to-date patient information for each visit. This reduces denial risks and improves process efficiency.
helps with
- Ensuring accurate patient information
- Reducing denial risks
- Improving process efficiency
Ineligibility Issues
Denials due to ineligibility are a major financial burden for medical practices. Up to 75% of claims can be rejected because a patient isn't covered for the treatment. This can happen due to inaccurate patient information, outdated details, or other issues. Synova uses real-time collaboration with insurance companies to ensure accurate information and reduce ineligibility denials.
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Complex and Changing Healthcare Dynamics
Owing to the complexities involved in the healthcare industry, patients fail to understand the nuances of their insurance coverage, as well as the information about the hospitals or doctors falling under their network. Synova addresses this by proactively contacting patients to clarify these complexities.
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Revenue Leakage
Prioritizing eligibility verification minimizes revenue leakage caused by claim rejections and denials. It also strengthens patient collection efforts and prevents payment delays, ultimately optimizing your revenue cycle.
Measurable Impact
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Reduced Denials and Rejections
Prior to service delivery, verifying patient eligibility and benefits ensures services align with their insurance coverage. This proactive approach minimizes claim denials and rejections due to ineligibility or lack of coverage, streamlining the claims processing experience.
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Accurate Demographic Information
Eligibility verification allows practices to accurately determine a patient's insurance coverage and report demographic information on the claim form.
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Reduced Payment Delays
Synova offers in-house data verification software which is fast and accurate, reducing payments delays.
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Reduced Administrative Costs
Synova automates eligibility and benefits verification, reducing administrative costs associated with manual processes. This minimizes errors and manual interventions, leading to increased operational efficiency.
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Optimized Revenue Cycle
Accurate verification at the initial patient encounter establishes a solid foundation for a smooth revenue cycle. It ensures all subsequent steps, from coding and billing to collections, are based on verified information, optimizing overall revenue cycle performance.
Collect Patient Information
The initial step involves the meticulous gathering of essential patient details. This encompasses personal information, insurance data (including provider name, policy and group numbers), and any other pertinent information. Typically, this collection occurs during patient registration or prior to the scheduled appointment.
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Verify Eligibility
We verify the patient's coverage and active status through an automated eligibility verification system or by contacting the payer.
Confirm Benefits
After verifying eligibility, we review the plan to determine the covered benefits, which include co-pays, deductibles, co-insurance, covered services, as well as any exclusions or limitations.
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Communicate with Patient and Update Records
After verification, we inform the patient about their coverage details and update the Practice Management or Electronic Health Record (EHR) system with the verified eligibility and benefits information.
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The process of confirming a patient's insurance coverage and the specific benefits they are entitled to under their insurance plan before providing healthcare services.
Eligibility and benefits should be verified at the time of scheduling, during pre-registration, and again on the day of the appointment to account for any changes in the patient's insurance status.
This process is crucial to prevent claim denials and rejections, ensure accurate billing, improve cash flow, enhance patient satisfaction, and minimize financial risks for healthcare providers.
Failure to verify eligibility and benefits can lead to claim denials, delayed payments, increased patient dissatisfaction, and higher administrative costs due to the need for follow-up and rework.
Verification can be done manually by contacting the insurance provider or electronically through automated verification systems that integrate with the provider's practice management or electronic health record (EHR) systems.
Yes, for many healthcare providers, Synova uses automated systems that integrate with insurance databases to verify eligibility and benefits in real-time, reducing administrative burden and errors.
Typically, patient's full name, date of birth, insurance provider, policy number, group number, and the specific service or procedure to be verified.
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Accelerated Outcomes
Value-driven Collaboration
Compliance Assurance
Bring a change to your Healthcare Operations
A partnership with Synova gives you an inherent:
Adherence towards federal, state, and organizational compliances, as well as safeguarding patient data.
Sense of ownership and commitment towards providing value.
Focus on speed, accuracy, efficiency, and optimal outcomes.
Sense of security and transparency through periodic reporting and actionable insights.
Connect with our experts for a quick analysis and possibilities.
