Accurate Insurance Verification to Maximize Reimbursements
Now, let us look at what this insurance verification process involves. The revenue and cash inflow of healthcare facilities largely depend on medical reimbursements and insurance claims. Many medical practices struggle with delayed or unpaid claims. Claims are delayed or unpaid when the patients are found ineligible for coverage. Proper insurance eligibility verification procedures would allow medical entities to maintain a steady revenue cycle. If health insurance verification is not completed properly, it can lead to a range of problems such as claim rejections, delayed payments, increased errors, need for rework, patient dissatisfaction, and non-payment of claims. To avoid claim denials, the insurance verification process must be performed well before the patient’s appointment date. All information provided must be confirmed, as even a simple error can lead to denial of claims. The following are some of the major processes involved in insurance benefit verification:
- Verifying patient insurance coverage
- Receiving schedules from the hospital via EDI, email or fax
- Contacting patients for additional information
- Updating the billing system with eligibility and verification details
To streamline the routine insurance eligibility verification procedures of your medical facility, the best option is to outsource medical insurance verification to an experienced medical billing outsourcing company. Most outsourcing companies are staffed with experienced and knowledgeable insurance verification specialists. These professionals consider all the aspects and verify patient information with the insurance provider, work with the patients and complete all paperwork. They verify aspects such as:
- Patient policy status
- Payable benefits
- Claims mailing address
- Type of plan and coverage details
- Co-insurances
- Deductibles
- Co-pays
- Effective date
- Plan exclusions
- Referrals and pre-authorizations
When a competent company provides insurance verification services, your claims will be processed without errors and submitted on time. This will enable you to save on operational costs that are otherwise required to carry out the verification procedures in-house. These services also ensure many additional benefits such as:
- Speed up approval and authorization
- Improved staff productivity
- Reduced effort and time
- Faster billing cycles
- Simplified workflow
- Concentrate on core competencies
Systematic insurance verification services along with improving the revenue also play an important role in enhancing the overall efficiency of medical practices. With a reliable firm to provide support, you can enjoy comprehensive benefits such as competitive pricing structure with 30% to 40% cost savings, free trial option, quicker and faster services, constant customer support, fast turnaround time and much more.