Patient Eligibility & Benefits and Pre-authorization
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Patient Eligibility & Benefits and Pre-authorization Zahid
Effective and efficient flow of patients and requisitions and the timely turnaround of associated claims are crucial to operational as well as financial success of Medical Diagnostic Labs (Reference/Independent or POL), Physician Practices, and Healthcare Facilities. As increasingly more financial responsibility has shifted to patients in the form of copays and deductibles, acquiring and using accurate eligibility and benefits information about the patient is vital to the overall financial health and growth of these providers.
Sypore recognizes the value and complexity of this task and the resource constraints faced by most healthcare services providers. For this reason, we offer our Patient Eligibility & Benefits (E&B) Verification Service in three delivery models to meet the needs of our customers:
Day advance E&B for scheduled patients
Real-time E&B Verification for walk-in and same-day patients
Enhanced E&B verification pre-authorization with 3-day advance scheduling
While most healthcare services providers would use the first delivery model for scheduled patients, some (e.g. Medical Labs and Urgent Care clinics) need the other two delivery models due to the nature of their operation. The benefits from this service are the following:
Better patient experience due to less time spent waiting for E&B verification
We do the legwork of getting the most up-to-date E&B information and make it available to your front office staff before the patient visit time in the case of advance scheduled patients and in real-time (while the patient waits just a few minutes) for the same-day patients. This frees your front-office staff to focus on the patients and give them a better experience, which is critical to your reputation and long-term success.
Accurate and actionable information to prevent financial losses
We provide you with crucial information about coverage, copays, and deductibles so that your staff may collect the right amounts from the patient even before the services are rendered. This not only prevents losses from patient responsibility amounts but also speeds up the cash flow – You get paid faster.
Less expensive than in-house staff
Using our engineered process supported by state-of-the-art technology, we can execute this crucial task faster, with better quality, and at a lower cost. This quality, speed, and cost efficiency enables us to offer these mission critical services to our customers at a fraction of what it would cost them to do it themselves.
A healthcare environment in which Physicians are clinically autonomous and free from administrative burdens, so that they are able to fully devote their time, talent, passion, and energy to patient care.
Excellence: Pursue excellence in everything we do
Fairness: Provide the best service our customer can rightfully expect, for a fair price
Respect: People matter, above all else
To help our customers get control over their time to spend it as they prefer and have the financial peace of mind from knowing that their cash flow is always maximized.