Insurance Verification Services - An Overview

Insurance verification services are a key component in the medical billing cycle. In health insurance verification, a patient's active coverage is checked with the insurance company to make sure that he/she is eligible for the procedure scheduled in the hospital. The verification should be done before the patient is admitted to hospital. By ensuring that patients are eligible for services and benefits before the treatment is rendered will help avoid the risk of not getting paid.

Medical insurance verification is a time consuming process that requires minute attention to detail. It prevents serious financial losses due to patient ineligibility. Besides, it helps you save the time spent on manual eligibility checks (up to 15 minutes per patient) and reduces human error. Payment collections can be significantly improved with accurate co-pays/deductibles info.

Because of their busy working schedules, most healthcare providers do not get enough time to carry out the verification process properly. Non-verification of insurance eligibility may lead to problems such as delayed payments, rework, increased errors and patient dissatisfaction. To avoid claim rejection, it is very important to carry out the insurance benefit verification process. In such circumstances most of the healthcare professionals prefer to outsource eligibility verification services to a reliable outsourcing company. Outsourcing frees up healthcare staff to focus on more productive tasks.

Insurance Verification Services – What Is Involved

Every medical professional must understand the importance of insurance verification in making the billing process successful. Here’s a quick overview of the entire insurance eligibility verification process.

Insurance benefit verification 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, life time maximum, and more. Insurance eligibility verification process involves the steps that are mentioned below:

•    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
•    Verifying demographic information
•    Updating patient accounts
•    Contacting patients for additional information if necessary
•    Updating the billing system with eligibility and benefits details such as member ID, group ID, coverage start and end dates, co-pay information

Seek Professional Help from a Reliable Service Provider

To get comprehensive insurance verification services, it is necessary to seek the help of an experienced and reliable medical billing company. A reliable company will help in all ways to meet your insurance verification requirements. By hiring a professional firm to meet your insurance verification requirements, you can gain many benefits including: reduced effort and time, speed up approval and authorization; simplified workflow; faster billing cycles; improved staff productivity and reduced operational costs.

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