The Power of Provider Portals

Posted by Daniel Ramsey on December 4, 2019
Daniel Ramsey
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Does your administrative staff spend hours on the phone trying to get claim status? Do they complain about long wait times when calling to verify patient eligibility? These problems could be eliminated with the use of insurance provider portals. Most insurance companies have provider portals available to help make the administrative duties easier.  

The Benefits of Provider Portals 

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1. Eligibility and benefit checks

Logging into a provider portal and entering a patient’s information is much quicker than calling the eligibility department and waiting on-hold for a representative.  

2. Verify claim status and reprocess denied claims 

Admin staff could call an insurance company to obtain claim status, or they could check claim status using the provider portal to save time and ensure accuracy. Some provider portals allow you to resubmit denied claims so there is no need to resubmit through the clearinghouse or print and submit claims on paper.  

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3. Obtain remittance advice 

Getting electronic remittance advice (ERA) through a provider portal eliminates the waste of paper EOB’s while allowing your staff to post payments into your billing system faster. Additionally, ERA’s remain in the provider portal for years before getting archived. 

4. Submit credentialing applications 

Many insurance companies have begun transitioning from paper credentialing applications to online apps. These electronic options decrease the likelihood of incomplete or inaccurate submissions.  

Where to Find Provider Portals? 

The best place to go to find the provider portal is the insurance company’s website. If you can’t find the portal on the website, call provider relations to inquire if one is available. Some insurance companies use a third-party provider portal, such as Availity, NaviNet or Optum, which allow you to access multiple insurance carrier’s information from one account. 

One of the first things we do when on-boarding a billing client is to set them up with all applicable provider portals to save time and ensure accuracy. Review the insurance companies you participate with and if a provider portal is available, take the time and register with each one. Your staff will thank you for making their job easier and you will be happy with how much more time they’ll have to improve the patient experience.  

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Topics: Billing, Front Desk

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