Automating medical insurance verification process through eligibility checker

The Medical Insurance Verification process comprises multiple tasks for medical institutions that offer insurance to eligible patients. To check any patient’s eligibility and benefits, healthcare facilities like hospitals and clinics have to undergo tedious tasks like making phone calls to gather their information and creating a database. Before simplifying the process, let us understand what Medical Insurance Verification is!

What is Medical Insurance Verification?

Medical Insurance Verification is determining a patient’s eligibility for medical coverage and verifying their insurance status. If the coverage is not verified, it may result in billing mistakes, payment holdups, and decreased earnings. Eligibility is regarded as the initial step in the verification process. The medical staff checks to see if the patient’s insurance is still in effect. The verification process itself provides more information on the patient’s advantages.

What is Eligibility Checker, and how does it automate the entire Medical Insurance Verification process?

Eligibility Checker automates the patient’s medical insurance eligibility and benefits verification inside Salesforce. It quickly determines patient responsibility for Copay, Coinsurance, Deductibles, and Out of pocket. This medical insurance verification solution provides access to 850+ commercial and government payers, including Medicare and Medicaid, along with real-time authorizations and look-up referrals. The solution is compatible with Health Cloud and Non-Health Cloud.

Cloud Maven, Inc., a certified Salesforce ISV Partner and the proud winner of the 2021 Salesforce Partner Innovation Award, has developed this product. Insurance companies have to perform tiresome work of calling patients for profile verification which causes an increase in manpower and errors. This Salesforce native app provide a streamlined experience for the insurance companies to minimize their manual work, automate the entire Insurance Verification process and remove all possible errors that may result in high time consumption and high capital spending on the system improving its functionality.

Through Salesforce Health Cloud or Service Cloud, this Medical Insurance Verification app provides simple integration into any current process. The prior authorization requirement ensures that authorization for treatment has been granted from the proper authorities, if applicable. It enables a secure and reinforced HIPAA-compliant cloud-based environment to safeguard private patient data and against potential data breaches.

The Insurance verification app can auto-populate patient information from any Salesforce object. The solution verifies that the patient had valid insurance on the service date, ensures that the authorization came from the proper sources, and records all the information directly inside the Salesforce CRM application. It provides 187 service categories for process-level verification through reporting and analytics, encourages fewer billing errors and denials, and provides customized reports.

By providing real-time medical insurance benefits verification, staff productivity gets optimized as the front office time is reduced along with 50% savings in terms of cost. Due to the reduced risk of rejected claims and no long-term contracts, patient satisfaction is improved, and their time is saved as they receive instant medical approval.

This Medical Insurance Verification software ensures healthcare information security and enables an enhanced user experience, making it different from other insurance verification solutions. With a free 30-day trial period, this application is available on Salesforce AppExchange. For any queries, send an email at info@cloudmaveninc.com, and make sure to follow Cloud Maven, Inc. on LinkedIn, Twitter, and YouTube for further updates.

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