Saturday, October 13, 2012

The Importance of Health Insurance Verification and Authorization Services 

Most of the medical professionals may not have enough time to supervise the medical insurance verification process and their staff may not be skilled enough to carry out the eligibility verification process efficiently. This often leads to a situation where you don't receive due payment for services provided. So, it is very crucial that healthcare providers understand the importance of insurance verification and authorization services in the healthcare industry.

Insurance verification services and insurance authorization plays a vital role in accelerating the medical billing process. It involves validating the patient's insurance details and obtaining assurance by calling the insurance payer or through online verification. The process ensures verification 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 & pre-authorizations, life time maximum and more.

Comprehensive Health Insurance Verification and Authorization

The insurance verification and authorization process includes:

•    Ensuring benefits for all patients prior to submitting to the insurance company for approval
•    Getting patient schedules from the hospital or clinic via FTP, fax or e-mail
•    Verifying patient information with the insurance carrier (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 and pre-authorizations, life time maximum and more)
•    Verifying patients’ insurance coverage on all primary and secondary payers
•    Updating patient accounts
•    Communicating with patients and completing paperwork
•    Updating insurance system with new and updated benefits
•    Obtaining pre-certification number from physician’s office if necessary
•    Completing appropriate criteria sheets and authorization forms
•    Contacting the insurance agencies via telephone call, facsimile or online program to obtain approval for your authorization request
•    Contacting insurance agencies for appeals, missing information and more to ensure accurate billing

It is advisable to avail of insurance verification services to enjoy maximum benefits. Outsourcing of health insurance verification and insurance authorization allows healthcare professionals to focus on their core business activities and provide quality healthcare.

Professional Medical Billing Company for Maximum Efficiency

Try to partner with a professional medical billing company that can work as an extension of your office. Normally, medical billing firms have a team of professionals who work with patients as well as providers to verify medical insurance coverage and generate claims for services rendered. They will also provide complete support to obtain pre-certification and or prior authorizations. They have:

•    Experience with insurance guidelines of various providers, knowledge of healthcare terminology, and medical/surgical techniques
•    Good communication skills
•    Good typing skills
•    Excellent computer skills
•    Call center/customer service experience

No matter whether you are an individual practitioner or running a faculty practice, health insurance verification services and insurance authorization are definitely beneficial.

Article Source: http://www.americanchronicle.com/articles/view/288423

2 comments:

  1. It is easier to outsource your medical billing . No hassle for the doctors since experts from outsourcing companies will take care of it.

    ReplyDelete