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How to Verify a Patient’s Insurance in eClinicalWorks (eCW)?

Verifying insurance eligibility is a crucial step in the patient registration and billing process within eClinicalWorks (eCW). Ensuring that patients have active coverage reduces claim denials, enhances cash flow, and helps avoid patient dissatisfaction. This guide provides a detailed process for performing both individual and batch insurance verifications in eCW.

Step 1: Access Insurance Verification for Individual Patients

• Open the Resource Schedule in eCW and locate the patient’s scheduled appointment.
• Right-click on the appointment and select Check Eligibility from the drop-down menu.
• Alternatively, double-click on the appointment to open the Appointment Window and click the Check link for eligibility.

Step 2: Review the Eligibility Check Status Report

• After selecting the eligibility check, the Eligibility Check Status Report window will appear. This report indicates whether the patient’s insurance is active for the date of service.
• Available Options:
  • Re-Submit: Allows you to resend the eligibility request if the initial verification fails.
  • Print: Prints the eligibility report for record-keeping.
  • Open New Report Viewer: Opens a separate viewer for in-depth analysis of the report details.

Step 3: Save and Close

• After reviewing the eligibility status, close the Eligibility Check Status Report.
• Add notes regarding the verification status in the appointment window, if needed, to assist the front-desk or billing team.

Batch Insurance Verification

For practices with high patient volume, batch insurance verification can save time and improve efficiency by verifying multiple patients’ insurance statuses at once.

Step 1: Open Batch Verification

• In the Resource Schedule, right-click on the E icon to access the Eligibility Admin window.

Step 2: Set Filters for Batch Verification

• Use filters to specify parameters, such as date range, provider, or facility, for the group of patients requiring eligibility verification.
• Applying filters ensures that only the relevant patients are included in the batch verification.

Step 3: Run the Batch Eligibility Report

• Once filters are set, run the report to verify insurance status for all selected patients.
• The results will display verification statuses for each patient, highlighting any issues that may need attention.

Why Insurance Verification Matters

Verifying insurance before each visit prevents billing errors, minimizes claim denials, and improves cash flow by ensuring that all services are covered. Accurate eligibility checks also reduce administrative burdens by addressing insurance issues before they affect billing.

Frequently Asked Questions (FAQs)

Q1: How often should insurance verification be performed for patients?
A: Insurance verification is recommended before every visit to ensure active coverage. Patients may experience changes in their insurance coverage, so routine checks help avoid billing surprises and claim denials.

Q2: What should I do if insurance verification fails?
A: If a verification fails, use the Re-Submit option to try again. If it continues to fail, contact the insurance provider to confirm coverage or inform the patient so they can follow up.

Q3: Can I verify insurance eligibility for a patient without an appointment?
A: Yes, you can verify eligibility by opening the patient’s profile and initiating an eligibility check. However, performing this check through the appointment screen is the most common method as it’s tied to the scheduled date of service.

Q4: What’s the difference between individual and batch eligibility checks?
A: Individual verification is done for one patient at a time, typically during appointment scheduling. Batch verification checks multiple patients’ insurance status simultaneously, useful for high patient volumes or upcoming appointments.

Q5: What are the benefits of batch insurance verification?
A: Batch verification is efficient for high-volume practices, saving time by verifying multiple patients at once. This method helps front-desk staff identify potential insurance issues for several patients in advance, reducing last-minute problems.

How Staffingly, Inc. Supports Insurance Verification in eCW

Staffingly, Inc. provides expert support for insurance verification within eClinicalWorks, including both individual and batch verifications. Our trained virtual medical assistants conduct timely, accurate eligibility checks, ensuring that the front-desk and billing teams have verified information for smooth operations. By outsourcing insurance verification to Staffingly, healthcare providers can reduce administrative tasks, avoid claim denials, and save up to 70% on staffing costs.

What Did We Learn?

Insurance verification in eClinicalWorks is a vital process for avoiding billing errors, enhancing cash flow, and improving patient experience. By following clear steps for individual and batch verifications, healthcare providers can efficiently confirm coverage, minimize claim issues, and ensure a seamless visit experience for patients. Reliable insurance verification processes are essential for reducing denied claims and ensuring that billing processes run smoothly.