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My office checks online to make sure that the patient has coverage, is that enough?
Confirming that a patient is covered under their health insurance is important, but is not always enough. There are other additional physician services that you may provide to the patient that may either not be covered under the policy, require pre-authorization or there may be other issues with the policy that the website will not tell you.

A proper and complete eligibility check is absolutely imperative to any medical officeís successful collections from insurance companies.

HealthQuist offers a complete eligibility check that includes the following:
  •   Patient Coverage Active or In-Active
  •   Effective Date of Policy
    •   Important to ensure pre-existing conditions are not an issue
  •   Physician in- or out-of-network
  •   Co-pay
  •   Co-insurance
  •   Total Deductible
  •   Amount of Deductible that is met, if any
  •   Any issues with the patientís plan, i.e.:
    •   COB
    •   Pre-existing condition, etc.
  •   Details of the plan as it pertains to practice specialty, examples include:
    •   If physical therapy, Medicare has a Cap on total amount per year, we will notify you the total
           amount met and remaining
    •   If you are a specialistís office, we will notify you if authorization is required for procedures
    •   Any other details that either you or your office thinks is pertinent, we will check
Please click here to view a sample Eligibility Report from HealthQuist.

By providing your office a detailed eligibility report, we find that denials are reduced because most issues are addressed with the patientís insurance company prior to the patient being seen.

What needs to be done for HealthQuist to perform my eligibility checks and provide a report to me each morning?

HealthQuist will either need access to your existing Scheduling / EMR / Practice Management system to obtain your daily schedule. If you are not keeping track of your appointments electronically or you would like to keep your scheduling combined with the billing system, HealthQuist will arrange for you to access our scheduling / practice management system.
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