What is the purpose of conducting an eligibility check in patient access?

The purpose of conducting an eligibility check in patient access is primarily to establish if the required services are covered by the patient's insurance. This process ensures that before any services are provided, the healthcare provider can confirm whether the patient's insurance plan will cover the cost of the anticipated treatment or services. This is crucial for both the provider and the patient; it helps the provider avoid financial loss and informs the patient of any potential out-of-pocket costs they may incur, which could influence their decision to proceed. By understanding coverage parameters, healthcare facilities can streamline revenue cycles, reduce claim denials, and enhance overall patient satisfaction by providing clear financial expectations.

While verifying a patient's identity, scheduling appointments, and accurately collecting demographics are important administrative tasks in patient access, they do not directly relate to understanding insurance coverage for services. Thus, they are separate functions and do not fulfill the primary purpose of an eligibility check.