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Failure to do so could leave your practice with an unpaid claim from the insurance company or a patient saddled with unexpected expensive bills.
Considered one of the most common causes of medical billing failure , ensuring proper insurance verification and pre-authorization enables faster and more efficient payments, reduced debts, and enhances patient satisfaction. Accurate insurance verification ensures a higher number of clean claims which speeds up approval and results in a faster billing cycle.
Inadequate verification of eligibility and plan-specific benefits puts healthcare organizations at risk for claim rejections, denials, and bad debt. Verifying the insurance coverage in advance, for procedures or equipment, results in fewer claims being denied. Since insurance information change frequently, failure to stay ahead of ever-changing regulatory requirements could lead to rejected claims, billing errors, and reimbursement delays. Nine in 10 consumers want to know their payment responsibility upfront.
An outsourced medical billing partner that offers HIPAA compliant medical billing takes the responsibility from your overworked staff. Analytix Solutions specializes in developing medical billing solutions that optimize many aspects of the medical billing process, including insurance verification.
First things first: If you want to head denials off at the pass , you gotta get some information from the patient, ASAP. The bulk of the reason why you should start the verification process early is that it can take some time to complete this second step.
This will ensure that you have all the information you need long before the patient walks through your doors. The most common way to contact payers and, incidentally, the most time-consuming is over the phone. The provider services line is just like any other customer help line out there; there will be busier hours and even days when more people tend to call in at the same time.
Here are some jumping off points for some common payers:. One caveat: Payer-supplied provider directories have been known to contain outdated information. In a perfect world, patients would remember to tell you the moment their insurance changes.
Melissa Hughes is a senior content writer for WebPT. As a trained award-winning journalist and a forever learner, she uses her passion for education and really bad puns to inform her writing—and ultimately to help rehab therapists achieve greatness in practice. Free Demo. In order to avoid claim rejection, the verification process must be done before the patient is admitted into a hospital.
Otherwise, it might lead to denials and need for rework. Patients would be ineligible for benefits when they provide wrong or outdated information, or when their policies have been terminated or modified. A simple error can result in claim rejection or denial, so you have to be sure it is being done correctly. A health insurance verification specialist, also called insurance verifier, plays a big role in the health insurance system.
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