ROLE OF INSURANCE ELIGIBILITY VERIFICATION SERVICES IN MEDICAL PRACTISES

Health insurance verification includes confirmation that a patient is covered under a health insurance plan. If insurance details and other details are not properly checked, then it can disrupt the cash flow of your practice by delaying or affecting reimbursement.

Every healthcare practices look for proof of insurance when patients register for appointments, and the process is completed prior to patient appointments.

Including capturing, and verifying demographic and insurance information, the healthcare staff has to perform some tasks such as eligibility services medical billing, sending patient statements, prepare patient files acquiring checking, and providing all patient insurance information requires great attention to detail, and is very difficult in a busy practice.

The service includes verification of:

 

  • Payable benefits
  • Co-pays
  • Co-insurances
  • Deductibles
  • Patient policy status
  • Effective date
  • Type of plan and coverage details
  • Plan exclusions
  • Claims mailing address
  • Referrals & pre-authorizations
  • Lifetime maximum, and more

 

Insurance Verification process

 

  • Receiving patient schedules from the hospitals
  • Verification of patient insurance coverage including the patient name, name of insured person, relationship to the patient, relevant phone numbers, date of birth, Social Security number, chief complaint, name of treating physician, date of service, type of plan (HMO or POS), policy number and effective date, policy coverage, claim mailing address, and so on
  • Contact the insurance company to verify coverage and benefits eligibility electronically or via phone or fax
  • Verification of primary and secondary insurance coverage
  • Communication with patients for clarifications or additional information
  • Completion of the criteria sheets and authorization forms

Seek Reliable Service Provider

Do not stress out while managing the tasks it is better to outsource insurance verification services, that can get your claims billed and processed accurately.  A reliable company will help in every way to meet your insurance verification demands. There are many advantages to hiring health insurance verification services from a reliable outsourcing company.

An established company has many specialists at its disposal, and offer the best of services in an efficient way. They will check for policy changes and updates, and take care of the entire paperwork and verification of patient information with the insurance provider to maximize your collections.

By outsourcing your requirements, you can gain many benefits including:

  • Patient responsibilities such as co-pays, co-insurances
  • Patient policy status
  • Effective date
  • Type of plan and coverage details
  • Plan exclusions
  • Claims mailing address

While deciding to outsource insurance verification services make sure to choose a firm that will provide services based on your budget constraints and unique requirements. You can search online to find many reputable service providers. By outsourcing their insurance verification jobs, most healthcare practices hope to gain more advantages such as:

  • Reduce operating cost
  • Expand company focus
  • Improve overall efficiency

Every healthcare should give importance to insurance eligibility verification healthcare services because this can greatly impact as it minimizes the chances of denial of your claims by scrutinizing the eligibility and benefits of the patient before the services are delivered.

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