Client Overview:
A mid-sized mental health service provider in Ohio, dealing with frequent eligibility denials and slow reimbursement processes.
Challenges Faced:
- High rate of eligibility denials
- Inconsistent insurance verification processes
- Delays in reimbursements due to eligibility issues
PhysiAssist’s Plan of Action:
- Real-time Eligibility Verification: Implemented automated eligibility checks at the point of care to ensure immediate verification and reduce the chances of errors.
- Staff Training: Conducted training sessions for front-office staff to improve understanding of insurance policies and common eligibility issues.
- Automated Claim Submission: Integrated automated claim submission tools that reduce human error and streamline the approval process.
- Proactive Payer Communication: Set up a communication system to interact with payers more efficiently, improving claims approval times and reducing denials.
Results:
- Reduced eligibility denials to below 3%
- Improved claim approval rate by 20%
- Accelerated payment cycles and reduced administrative burden