With the large number of eligibility software products available, it’s becoming increasingly difficult to find the perfect option for your company. You may actually run across more inappropriate choices than an appropriate one.

Here are 6 clues that will help you to quickly identify software that you should avoid.

    1. Increasing Fees or OveragesIf you pay for eligibility checks by the transaction or click, you will find that the fees add-up quickly. With a variable-cost pricing model, you can never predict how much your eligibility fees will be and if you have a particularly active month, you may easily exceed your budget or estimated purchase order. Subscription-based, flat-fee software is an easy remedy for fee increases and budget overages.

 

    1. Eligibility Slipping through the Front-End CracksIn an attempt to save money by keeping eligibility transactions to a minimum, you can cause claims payments to be delayed or slip through the cracks when placed as a TBDL (to-be-done-later) task for corrections and re-checks. The bottom line is that your organization risks not being paid on a claim when this happens. Choose software that’s comprehensive and easy-to-use that doesn’t penalize you by adding additional cost for every transaction. Slippage will nearly disappear.

 

    1. Increasing Self-Pay or CollectionsMore than 26% of U.S. families struggled with the financial burden of paying medical bills in 2012 based on a study conducted by the CDC. In most cases, these bills are eventually charged off, sold to collections agencies for a reduced price, and remain unresolved and on your books for years. Look to structured real-time processing for a quick turnaround of benefits verifications – encouraging frontend transactions and eligible benefit discovery, decreasing collection agency pileups and their additional finders fee.

 

    1. Decrease in Collecting Money at the Point of Service (POS) “How would you like pay today?” can only be asked if you know what the bill will be. You can’t know what the bill will be without knowing patient’s up to date benefits coverage. In addition to decreasing your frontend revenue, this also decreases the “convenience factor” that today’s consumers place as a priority during most shopping experiences – including healthcare services.

 

    1. Poor Patient Service, Decrease in Patient SatisfactionOften, patients’ satisfaction is directly attributable to understanding the service and the benefits they have. It’s also heavily affected by how smooth the registration process is. Key to these are accurate eligibility verification. Look for software that integrates all payors’ data so patient access professionals know immediately how to manage patient expectations. Having an up to date, printable, and easy to read benefits summary will give both registration professionals and your patients the information needed to seamlessly transition through the process.

 

  1. Increase in Time to Accomplish TasksMany professionals don’t trust the accuracy or robustness of their eligibility verification software and processes. They’re frustrated because it takes them more time during registration and verifying the verification! It’s not unusual for people to have to use multiple payer portals or to make calls to payers to get what they need to process and patient. Look for software that integrates all payers into one system for a single view. Not only does this save time looking up benefits, it greatly improves the accuracy of the data so your organization is not left with one of the many common back end problems such as coordination of benefits or demographic errors.