Patient Eligibility Accuracy Rate
This PDF report includes benchmarking data (in a visual, chart-based format), an comprehensive KPI definition, characteristics of high performers and technical details on measuring Patient Eligibility Accuracy Rate. Purchase and download this easy-to-understand, presentation-ready report immediately to compare performance levels, set attainable performance targets, and push towards best-in-class performance for this KPI.
What is Patient Eligibility Accuracy Rate?
The number of instances where the patient eligibility information initially returned by the health insurance company matched the final outcome of claim adjudication divided by the total number of claims adjudicated by the insurance company over the same period of time, as a percentage.
Why should Patient Eligibility Accuracy Rate be measured?
Patient Eligibility Accuracy Rate measures the overall quality and accuracy of the patient eligibility information provided to healthcare providers by insurance companies regarding medical services to be provided to patients. A high accuracy rate here is important, because it allows healthcare providers to identify and resolve any eligibility-related issues prior to performing the medical service, or prior to submitting the claim to the payer for processing (i.e., avoiding a denial or additional rework). A higher than desired rate of inaccurate patient eligibility information can greatly diminish customer service levels, lead to rework and reduced capacity within the claims function (and for administrative functions within healthcare providers), and may lead to costly disputes with healthcare providers (e.g., doctors, hospitals, etc.).
Download a Sample Patient Eligibility Accuracy Rate
Frequently Asked Questions
Q: How do you collect and validate your data?
A: From real-world consulting engagements with Fortune 500 leaders. We’ve spent 25 years conducting original research and anonymizing data from our engagements with top companies around the world. Every single data point we collect is scrutinized by our analysts to conform to established baselines and our rigorous in-house validation process. We won’t serve it up to you unless it meets our tough standards for utility and value.
Q: How much information will my Benchmarking Report contain?
A: Enough to produce a useful benchmark. And rest assured that it’s all current, validated, and useful. We only include data that’s been collected in the last five years. And while sample sizes vary by KPI, the average is 25, and the high end can surpass 1,000.
Q: How often do you update your reports?
A: Every year. We’re constantly gathering, scouring, and processing new data. We update our reports based on trends our analysts detect in the data, as well as the demand from our consulting clients and customers like you.
Q: Your download-able reports look great. But I need something custom. Can you help?
A: Heck yes. Our crack research teams just love custom assignments, and would be delighted to perform targeted research tailored to your specific requirements. Find out just how fast and affordable this is: Email us (email@example.com) or call us at 866.650.2888 and one of our friendly professionals will be happy to answer all your questions.