Undeniably, physicians need a stable revenue cycle. To achieve this complex goal, medical billing services work day and night to reimburse claims for them. It is their job and a way to give back. Eventually, efforts like these sum up to reflect better reimbursements and stability for a practice. If your practice’s focus is on developing a strategy for effective billing, the rest is easy.
Besides, it is crucial to verify the insurance eligibility of providers.
Medical billers have to find an answer to this question: Whether the patient’s health plan covers the treatment and the provider or not? Also, if the provider is out-of-network, it gives billing companies a chance to enroll them with the insurance company.
On the other hand, patients also have a responsibility to fulfill; they must keep their health plan updated. We are here to spread this sort of awareness, so they receive the healthcare they deserve.
The article discusses such a topic so the providers can get the most out of insurance companies maximizing their revenue. The RCM process is the backbone of practices!
Let’s not wait anymore and delve into how medical billing companies can verify insurance eligibility in 10 easy steps.
Obtain Important Information from the Healthcare Provider
The process starts when the patient visits a medical practice. It is where the front-desk staff accurately records patient information. Such information includes:
- Name of the patient
- Date of birth
- Social security number
- Contact number
- Information of insurance provider
- Insurance ID & group number
Medical billing services have to find this information if healthcare providers don’t provide it, because, without it, it would be difficult to verify their insurance eligibility. Moreover, P3 Healthcare Solutions has a staff of billers and coders to expedite the process of verification.
Ask for the Original Health Insurance Card from the Patients
Request the patient to provide the photo ID and make copies of the original health insurance card for the future.
Contact the Respective Insurance Company
Make a call to the relevant insurance company or via electronic means, check if the insurance that patient claims, is valid.
Research If the Insurance Benefits Remain Valid on the Date of Treatment
Verifying the patient’s health plan saves providers from unnecessary stress. In short, it is the additional job of medical billing services to verify and confirm a patient’s eligibility.
Check for Insurance Benefits
By contacting the insurance company, medical billing services verify the benefits that a patient can avail and the copayment that they have to pay.
If there are charges that insurance doesn’t cover, make sure to inform the patient before the treatment, so that, they recognize their financial responsibility before time.
Ensure You Are Included in the Patient’s Insurance Network
If the healthcare provider is not included in the patient’s insurance network, the insurance company may not reimburse completely to the doctor.
Know About Deductibles
A deductible is an amount that the patient pays before the insurance company pays for them. There is a different amount for each insurance plan that a patient has to pay. In fact, medical billing companies need to ensure if the patient has paid the respective dues or not.
Collect copayments from the patient, give them a slip, and share with them the treatment details. In this way, patients get to know their insurance benefits too.
Be Efficient with Customer Support Services
Ordinarily, healthcare providers are busy people. It is not advisable for them to treat and charge patients at the same time. Therefore, medical billing services come to their rescue to deal with their payment matters. Besides, the front desk staff assists the patients for clarity in this regard.
Verify If the Patient Has a Secondary Insurance
Often patients have secondary insurance. Only a certain amount of charges is covered by the primary plan. It is advisable to verify secondary insurance information too as described above.
Medical Billing Services for Small Practices
‘Medical billing near me’ is often the search phrase providers search in Google for the nearest billing services. However, it is not a matter of distance but experience. Whether you are a small practice or a big one, one cannot deny the value of experience. Moreover, if the company maintains quality staff; online and offline reputation; and, high first-time claims acceptance rates, practices are bound to flourish within no time.
As a matter of fact, they help physicians to join the insurance network and demonstrate efficiency. It is necessary to kickoff their revenue cycle.
Successful medical billing companies ensure practices that best suit the healthcare service provider and elevate his revenue cycle. Insurance verification serves the same purpose. If the insurance verification process is completed beforehand the treatment, patients know about their financial responsibilities, and the rate of accounts receivable (AR) is reduced.
What do you think of the whole insurance verification process?