How to Verify Healthcare Insurance: Step By Step Guide for Medical Billing Services!

There is no doubt in it that physicians need revenue for their survival, and medical billing services work day and night to help them meet their expenses efficiently. They focus on developing a strategy for an efficient billing solution to maximize revenue.

Besides the other medical billing and coding procedures, verifying the eligibility of health insurance before the patient’s treatment also maps out a financial situation for physicians. Not only, it is an important revenue increasing practice for healthcare organizations, but is also beneficial for patients.

Given below is a guide on how medical billing companies can verify insurance eligibility in 10 easy steps.

Let’s check out!

Obtain Important Information from the Healthcare Provider

When a patient visits a doctor, it is the responsibility of the front-desk staff to accurately record patient’s information. The information includes,

  • Name of the patients
  • Date of birth
  • Social security number
  • Contact number
  • Information of insurance provider
  • Insurance ID & group number

Medical billing services need to access this information, if healthcare providers don’t provide them with the accurate patient’s bio; it would be difficult for them to verify eligibility.

Ask for Original Health Insurance Card from the Patients

Request the patient to provide with 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 date of patient’s health insurance safes from unnecessary stress in future. This information has to be checked with the insurance company.

Check for the Insurance Benefits

By contacting with the insurance company, medical billing services also need to verify about the benefits that a patient can avail and the copayment that he has to pay by himself.

If there are charges that insurance doesn’t cover, make sure to inform the patient before the treatment, so that, he recognizes his financial responsibility before time.

Check If Your Healthcare Provider is included in the Patient’s Insurance Network

If the healthcare provider is not included in the patient’s insurance network, the chances are that the insurance company will not pay the whole reimbursement.

Know About the Deductibles

Before the insurance company pays for the services, the deductible is the amount that the patient pays. There is a different amount for different insurance plans. Medical billing companies need to ensure if the patient has paid the respective dues or not.

Verify Copayments

Collect copayment from the patient, give them a slip, and provide them with treatment details. In this way, patients can verify their insurance benefits by themselves.

Be Efficient with Customer Support Services

If patients need assistance in any matter, answer their queries efficiently. Generally, healthcare providers don’t have time to deal with patients regarding payment matters, so the front desk staff does it.

But, if the reception staff is not capable to provide such information to the patients, the medical billing staff has to take care of this responsibility as well.

Verify If the Patient Has a Secondary Insurance

Often patients have secondary insurance and a certain amount of charges is covered in that plan. It is advisable to verify secondary insurance information, the same way as above-mentioned.

Successful medical billing companies ensure practices that best suit the healthcare service provider and elevate his revenue cycle. And, insurance verification serves the same purpose. If the insurance verification process is completed beforehand the treatment, the rate of accounts receivable (AR) is reduced. Moreover, patients know about their financial responsibilities as well.

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