Insurance Verification Services - Minimize Delays, Improve Collections

By Author: Outsource Strategies International
Total Articles: 109
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Insurance companies continuously make changes in their health insurance policy. So, health insurance verification services have become a necessity in the medical billing process to verify whether the patient is covered under the new plan to help achieve maximum benefits of insurance. Lack of proper eligibility may lead to problems such as:

Delayed payments
Increased errors
Need for rework
Non-payment of claims
Patient dissatisfaction

So in order to minimize delays and improve collections, many healthcare organizations have started outsourcing their insurance eligibility verification tasks. Insurance verification services ensure substantiation of payable benefits, patient details, pre-authorization number, co-pays, co-insurance details, deductibles, patient policy status, effective date, type of plan and coverage details, plan exclusions, claims mailing address, referrals and pre-authorizations, life time maximum and more.

Besides reducing delayed payments and improving collections, medical insurance verification provides you with a wide range of benefits including:

Improved ...
... cash flow
Reduced costs (30 to 40% below operational)
Increased efficiency
Reduced denial of claims
Reduce lost revenue in collections
Increased staff productivity
Increased patient satisfaction
Increased number of clean claims
Improve patient care
Reduce time spent following up on claims
Increase office efficiency
Reduced effort
Speed up approval and authorization
Simplified workflow
Increased number of clean claims
Faster billing cycles
Improved staff productivity
Reduce your risk factors
Reduced rework of claims
Maximize office efficiency and economies of scale
Expand company focus
Devote more time to core business objectives
Reduce time spent following up on claims

The process of health insurance verification involves a number of important steps:

Receive schedules from the hospital (Via FTP, Fax or E-mail)
Verify coverage on all primary and secondary payers
Contact patient for additional information if required
Provide the client with the results which include eligibility and benefits information such as member ID, group ID, coverage end and start dates, co-pay information and much more.
Enter and update patient demographics

If necessary, insurance verification specialists will help in:

Obtaining pre- authorization number
Reminding patient of POS collection requirements
Obtaining referral from PCP
Informing client if there is an issue with coverage or authorization
Medicaid enrollment

In short, insurance eligibility verification minimizes the chances of denial of your claims by scrutinizing the eligibility and benefits of the patient before the service is being delivered to him/her. Less number of denials means more number of clean claims, which means improved collections, and higher inflow of payment.

Outsource Strategies International (OSI) provides medical billing & coding, dental billing & coding, insurance & eligibility verifications to medical and dental practices.