verification services include the process of validating the patient’s
insurance details by calling the insurance payer or through online verification.
Payable benefits, patient details, pre-authorization number, co-pays, co-insurance
details, deductibles, patient policy status, effective date, type of plan and
coverage details, plan exclusions, claims mailing address, referrals and
pre-authorizations, and life time maximum are among the various details that
reveals that 75 percent of all healthcare claim denials are for the reason that
a patient is ineligible for services billed to the insurer by the provider.
Ineligibility for the benefit is due to the modification or termination of
policy. Non-verification of insurance eligibility may lead to several problems
such as delayed payments, rework, increased errors and patient dissatisfaction.
companies continuously make changes in their health insurance plans and
policies. So, it is very important for the medical
billing company to verify whether the patient is covered under the new
health insurance plan. With effective insurance verifications, you can
considerably reduce accounts receivable days and increase revenue, by reducing
the impact of ineligibility, and increasing the number of error-free claims
that are sent to insurers.
Insurance verification services - the first step in the medical billing process - involves:
- Receiving patient schedules from the hospital or clinics via FTP, email or fax
- Verifying patients' insurance coverage on all primary and secondary (if applicable) payers with the help of websites like WebMD, Payer Web Sites, Automated Voice Responses and phone calls to payers.
- Verifying demographic information
- Updating patient accounts
- Contacting patients for additional information if required
- Updating the billing system with eligibility and benefits information such as member ID, group ID, coverage start and end dates, co-pay information and much more.
Other optional services which are provided as a part of insurance eligibility verification include: obtaining pre-authorization number; reminding patient of POS collection requirements; obtaining referral from PCP; informing the client if there is an issue with coverage or authorization; Medicaid enrollment and more.
minimizing accounts receivable cycle, health
insurance verification services provide
you with a wide range of benefits including:
- Improves cash flow
- Increases office efficiency
- Reduces operating costs
- Increases upfront collections
- Reduces claim denials
- Reduces lost revenue in collections
- Increases staff productivity
- Increases patient satisfaction
- Increases number of clean claims
- Enables you to provide improved patient care
Find a Reliable Service Provider
Even though insurance verification services can provide you with a wide range of benefits, it’s important to select the right service provider. Once you are sure about the reliability of the service provider, simply utilize insurance verification services from the firm, and you can be assured of accurate and timely insurance benefit verification.