Streamlining patient affordability claim procedures for in-office healthcare services is a problem that requires a sophisticated solution. It can be easy to fall into the snare of seemingly endless paperwork, backlogged claims, and lack of patient retention without the proper systems in place.
From appointment to payment, a claim’s journey can be quite lengthy, with at least a half-a-dozen steps in the process. It can become especially tricky when attempting to implement medical benefit solutions on your own. The process typically goes something like this:
- A patient comes into the office for an appointment, and services rendered are coded and submitted.
- Primary payor claims are submitted electronically or with more conventional methods like paper and mail.
- Paper claims are scanned or manually entered by insurance professionals.
- The patient’s coverage at the time of service is confirmed.
- Claim validity is evaluated.
- The patient file is reviewed for identification of covered services and the treatment is verified as a medical necessity.
- Provider payment is either rendered or denied.
- Secondary payor: along with any applicable affordability solution designed to make the visit or treatment affordable is applied.
So, what can providers do to ensure this process is efficient, payment is swift, and that patients can continue therapies that they need? The answer is Paysign’s Medical Benefit Solutions.
Clinically based therapies have the same affordability needs as pharmacies. Both struggle to balance the cost of care with patient need. Our Medical Benefit Solutions operate much like traditional copay programs. But our solutions utilize the medical billing and payment systems used by hospitals, doctor’s offices, and providers.
This streamlined process allows providers to submit electronic or paper medical claims to help patients afford therapy or related services. These claims have custom business rules and payment rates that will match the needs of the patients.
“Implementing the correct systems is paramount not just to efficiency and overall patient satisfaction but also to ensuring the ability to continue treatment,” Paysign’s Vice President, Head of Patient Affordability Services, Matt Turner said. “The key is streamlining the process of covering products and services traditionally billed on medical claims by positioning an affordability program with a benefits solution.”
Paysign’s Medical Benefit Solutions are highly customizable and designed in-house with the specifications to pair with your brand strategy. From drug administration to lab work, office visits, and almost any other procedure needed, a Medical Benefit Solution from Paysign can change the way you’re doing business.