Insurance verification Services
Verifying insurance benefits of a patient is a very important pre-registration process. In the entire medical billing process, getting paid the first time is the key to effective revenue cycle management. Timely insurance verification helps to decrease claim denials and get clams paid faster. A good verification should be able to save cost and increase efficiency to a practice. Insurance verification includes identifying the primary insurance, secondary insurance, co-pays, deductibles, authorization, referral, coverage effective date, claims mailing address and type of services covered. In healthcare industry insurance verification is done to reduce the risk of claim denials.
Usually many claims get denied due to patient's ineligibility or specific types of services are not covered under their health plan. Increase in denials totally affects the cash flow of the practice. A good insurance / benefits verification significantly increases revenues and reduces unnecessary denials. Insurance companies have strict claim submission guidelines. If claims are not submitted within their time limit, they are denied.
A clean claim includes correct CPT codes, ICD codes, valid authorization number, referral number, date of service and modifier. Insurance verification services ensure to verify all the required information for a clean claim. Insurance verification has been a time consuming process but latest developments in technology has made real time online verification possible. Outsourcing insurance verification process has become a common factor as providers understand the importance of it.
Insurance verification workflow:
> A list of patients scheduled for treatment are received from healthcare provider
> Insurance verification specialists start to work on the list
> Verification is done by making calls to insurances companies or by using online verification portals.
> All required benefit information are verified
> Pre-authorization for services are received
> All received information are documented in the billing software
> Customized client reports are provided back to the provider's office.
Effective on time insurance verification services help the providers to save time, money and increase revenues. An experienced verification specialist would be able to execute this process efficiently.