Patient eligibility verification, or PVE as it is also known, has long been an important part of the medical billing process for healthcare providers. It’s been around for decades, and it isn’t going anywhere in the foreseeable future, so you might as well start learning how to take advantage of this time-saving service when you can!
Read on to learn more about why patient eligibility verification is important for billing healthcare services!
Eligibility Verification is a step of an organization’s process to help identify and/or document if a patient is eligible for their particular product or service. More often than not, it is necessary to submit documentation to verify that one is eligible. It ensures that patients are rightfully given access to a service they may need. It’s important because it stops people from using services they don’t actually need, which in turn helps with cost control. In some cases, organizations will refuse treatment to those who don’t meet eligibility requirements due to fear of medical liability lawsuits arising from missed diagnoses or delayed treatment.
For example, Medicare eligibility verification checks to see if a patient has all of his or her insurance benefits and can have a service covered. Hospitals must verify eligibility for private-pay patients, too. The type of verification that needs to take place depends on who will be paying for care.