Insurance Verification Services – Minimize Delays, Improve Collections
Insurance companies continuously make changes in their health insurance policy. So, health insurance verification services have become a necessity in the medical billing process to verify whether the patient is covered under the new plan to help achieve maximum benefits of insurance. Lack of proper eligibility may lead to problems such as:
- Delayed payments
- Increased errors
- Need for rework
- Non-payment of claims
- Patient dissatisfaction
So in order to minimize delays and improve collections, many healthcare organizations have started outsourcing their insurance eligibility verification tasks. Insurance verification services ensure substantiation of 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, life time maximum and more.
Besides reducing delayed payments and improving collections, medical insurance verification provides you with a wide range of benefits including:
- Improved cash flow
- Reduced costs (30 to 40% below operational)
- Increased efficiency
- Reduced denial of claims
- Reduce lost revenue in collections
- Increased staff productivity
- Increased patient satisfaction
- Increased number of clean claims
- Improve patient care
- Reduce time spent following up on claims
- Increase office efficiency
- Reduced effort
- Speed up approval and authorization
- Simplified workflow
- Increased number of clean claims
- Faster billing cycles
- Improved staff productivity
- Reduce your risk factors
- Reduced rework of claims
- Maximize office efficiency and economies of scale
- Expand company focus
- Devote more time to core business objectives
- Reduce time spent following up on claims
The process of health insurance verification involves a number of important steps:
- Receive schedules from the hospital (Via FTP, Fax or E-mail)
- Verify coverage on all primary and secondary payers
- Contact patient for additional information if required
- Provide the client with the results which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information and much more.
- Enter and update patient demographics
If necessary, insurance verification specialists will help in:
- Obtaining pre- authorization number
- Reminding patient of POS collection requirements
- Obtaining referral from PCP
- Informing client if there is an issue with coverage or authorization
- Medicaid enrollment
In short, insurance eligibility verification minimizes the chances of denial of your claims by scrutinizing the eligibility and benefits of the patient before the service is being delivered to him/her. Less number of denials means more number of clean claims, which means improved collections, and higher inflow of payment.
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