Health insurance verification is the process of confirming that a patient is covered under a health insurance plan. If insurance details and demographic details are not properly checked, it can disrupt the cash flow of your practice by delaying or affecting reimbursement. Therefore, it is best to assign this task to a professional service provider. Here's how insurance verification services help medical practices.
Gains from Competent Insurance Eligibility Verification Services
All healthcare practices look for proof of insurance when patients register for appointments. The process has to be completed prior to patient appointments. In addition to capturing and verifying demographic and insurance information, the staff in a healthcare practice has to perform an array of tasks such as medical billing, accounting, sending out of patient statements and prepare patient files Acquiring, checking and providing all patient insurance information requires great attention to detail, and is very difficult in a busy practice. Therefore more and more healthcare establishments are outsourcing health insurance verification to competent companies that offer comprehensive support services such as:
• Receipt of patient schedules from the hospital or clinic via FTP, fax or e-mail
• Verification of all necessary information such as 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 for each account to verify coverage and benefits eligibility electronically or via phone or fax
• Verification of primary and secondary insurance coverage and network
• Communication with patients for clarifications, if necessary
• Completion of the criteria sheets and authorization forms
One of the greatest advantages of outsourcing this task to an experienced company is that they have a specialized team on the job. With a clear understanding of your goals, the team works to resolve potential problems with coverage. By taking on the workload of insurance verification, they help you and administrative staff focus on core tasks. Other assured gains:
• Streamlined workflow • Fewer claim denials • Speedy billing cycle • Saved time • Quick insurance verifications and authorizations • Improved staff productivity • Simplified medical billing process
Companies that offer this service to help medical practices also offer efficient medical billing services. With the right service provider, you can save up to 30 to 40 per cent on your insurance verification operational costs.
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