The Challenges of January Reverification Season

The Challenges of January Reverification Season

For healthcare practices, the beginning of the year often brings a flurry of administrative tasks that can be overwhelming. January, in particular, is known for its reverification season—a critical period where practices must confirm patients’ medical benefits. This process ensures that patients receive uninterrupted care and that providers are reimbursed accurately. However, it comes with its own set of challenges.

One of the most significant hurdles is overwhelming patient outreach. Practices must contact a large number of patients to verify their information, which can be time-consuming and resource-intensive. Additionally, staff turnover during this period can exacerbate these challenges, creating a gap in experience and efficiency.

Another major issue is conflicting payer information. Different insurance companies may provide inconsistent data, leading to confusion and delays. This is further complicated by IVR loops and delays, where automated phone systems can trap staff in endless cycles of waiting and navigating menus.

Adding to the complexity, termed plans and Medicare switches often occur at the start of the year, requiring practices to update their records and ensure compliance. All these factors contribute to a claims backlog, which can delay reimbursements and strain the practice’s financial health.

Introducing eBlu Solutions’ Blizzard Mode: An Overview

Enter Blizzard Mode by eBlu Solutions—a game-changer for healthcare practices during the January reverification season. Designed to tackle the unique challenges mentioned above, Blizzard Mode automates and streamlines the benefit reverification process, making it more efficient and less burdensome for healthcare providers.

Blizzard Mode kicks in during January, leveraging pre-set reverification schedules that were established in December. Once these schedules are shared, eBlu Solutions takes over the heavy lifting, allowing practices to focus on patient care rather than administrative tasks.

This innovative feature ensures that all reverifications are completed promptly, with results available at least three days before the patient’s appointment. By automating the bulk of the work, Blizzard Mode significantly reduces the administrative burden on healthcare practices, allowing them to operate more smoothly during the busy January period.

How Blizzard Mode Simplifies Benefit Reverification

Blizzard Mode simplifies the benefit reverification process through a series of automated steps that ensure accuracy and efficiency. The process begins with the upload of schedules in December. Practices can provide essential information such as appointment dates, patient names, birth dates, and the drug names involved so eBlu Solutions can get a jump start on reverifications.

Once the schedules are uploaded, eBlu Solutions prepares patients for reverification in bulk batches according to their appointment dates. These batches are then run automatically starting January 1st. The results are processed quickly, with 83% of benefit verifications returned in less than 60 seconds.

The system also features a BI Batching Tool, which groups benefit inquiries based on appointment dates. This tool provides quick and easy access to results, allowing practices to review and act on them promptly. Sponsored drugs benefit from a 24-hour turnaround, ensuring that even urgent cases are handled efficiently.

Step-by-Step Guide to Preparing for Blizzard Mode

To make the most of Blizzard Mode, healthcare practices should follow a few preparatory steps. First, it’s crucial to upload January and February schedules by December 12th. This can be done by visiting the “Help Desk” and submitting an excel spreadsheet with the required information.

Next, practices should familiarize themselves with the BI Batching Tool. This tool will be instrumental in managing and reviewing benefit verifications. Training sessions are available to help staff understand how to use the tool effectively.

Once the schedules are uploaded, practices should continuously monitor their accounts for results and any outlier actions that may be needed, such as completing missing information. This proactive approach will ensure that all reverifications are completed smoothly and on time.

Ensuring Timely Results with Automated Processes

One of the standout features of Blizzard Mode is its ability to deliver timely results through automated processes. By automating the bulk of benefit verifications, practices can be assured that results will be ready at least three days before the patient’s appointment date.

This automation reduces the reliance on manual processes, which are often time-consuming and prone to errors. Instead, practices can focus on reviewing results and addressing any outliers, such as incomplete information or urgent cases.

The system’s efficiency is further highlighted by its ability to return 83% of benefit verifications in less than 60 seconds. This speed not only reduces administrative burdens but also ensures that patients receive timely and uninterrupted care.

 Managing Outliers and Urgent Appointments Effectively

While Blizzard Mode automates most of the benefit verification process, there will always be outliers and urgent appointments that require special attention. Practices should have a plan in place to manage these exceptions effectively.

First, it’s essential to review batches daily during January and February for any incomplete patients or treatments needing to be added. This proactive approach ensures that no patient falls through the cracks.

For urgent appointments or newly added patients, practices can submit benefit investigations manually through eBlu Solutions. Although last-minute escalations cannot be guaranteed, this option provides a safety net for managing critical cases.

Maximizing Efficiency with eBlu Solutions: Real-world Success Stories

The impact of Blizzard Mode on healthcare practices is best illustrated through real-world success stories. Practices that have adopted this innovative solution report significant improvements in efficiency and reductions in administrative burdens.

For example, one practice noted that the BI Batching Tool allowed them to manage large volumes of benefit verifications without overwhelming their staff. The tool’s user-friendly interface and quick access to results made it easier to stay organized and efficient.

By leveraging eBlu Solutions’ Blizzard Mode, healthcare practices can navigate the challenges of the January reverification season with ease. This innovative solution not only streamlines administrative workflows but also ensures that patients receive the care they need without delays.