In Insurance Eligibility Verification

If you want to run an efficient, successful practice, then you know that verifying patient insurance benefits is incredibly important. Even though your professional training may be in medicine, you also need to make sure you generate enough revenue for your practice. If you do not verify insurance benefits for your patients, you may end up providing services without getting your claims paid out. Therefore, understanding how to verify patient insurance benefits accurately and efficiently, can help your practice. What do you need to know about this process?

Why Verifying Insurance Benefits Is Important

First, it is important to understand why verifying patient insurance benefits is important. Some of the reasons why this is critical include:

  • You can maximize the cash flow coming into your practice. Verifying patient insurance coverage will lead to fewer denied claims, which will increase the number of claims that are paid out on time.
  • You can minimize the number of denied claims. Sometimes, patients can change insurance carriers, and you may not realize it. As a result, you may be operating under the assumption that their insurance plan is different than it actually is. This could lead to a denied claim you could have avoided if you simply verify their insurance coverage.
  • You can keep your patients happy because you can give them more transparency regarding the cost of the visit. You do not want your patients to be blindsided by a large bill, and verifying their insurance coverage can prevent that.

Even though verifying patient insurance status through insurance eligibility verification is not exactly the most exciting part of your job, it is no less important. Therefore, you must make sure you understand how to do this properly.

Crucial Steps in Verifying Insurance Benefits

If you want to verify patient insurance coverage properly, there are several steps you need to follow. They include:

  • You must collect insurance information from your patients during the intake and registration process. You need to ask who their insurance carrier is, group number, patient insurance ID, and policy number.
  • Remember that some people, such as children and spouses, may have a different policyholder than themselves. If that is the case, you need to verify that someone else is actually covering them through their insurance policy.
  • After this, you need to reach out to the insurance carrier to ensure that the patient is actually covered and the practice will be reimbursed for services rendered. That way, you understand what is covered and what is not.
  • Keep in mind that patients can change insurance carriers from time to time. Therefore, it is important to perform this process at every visit. When the patient provides you with their current insurance card, you need to verify benefits and coverage. 

If you train your office staff to do this process at every visit, you can maximize your revenue.

What Is the Difference Between Insurance Verification and Insurance Authorization?

You may have heard about insurance verification and insurance authorization. These are two different processes. Insurance verification refers to making sure patients who come to your practice have medical insurance coverage. That means you have someone to bill for your services.

This is different from insurance authorization, which refers to reaching out to an insurance company to get the approval to perform a certain procedure or give a certain medication before you do so. Sometimes, medications and procedures require prior authorization from the insurance company prior to rendering services. That is the process of insurance authorization.

Work With DataMatrix Medical To Verify Patient Insurance Coverage Efficiently

Even though you might be able to do this process independently, you can save time if you reach out to a professional service that can handle this for you accurately. At DataMatrix Medical, we have an experienced team that can help you expedite the process of insurance verification. That way, you can focus on taking care of patients while we worry about the administrative burden of verifying insurance coverage with insurance carriers. Give us a call today to learn more about how we can help you with insurance verification and authorization needs.

Recent Posts
real-time insurance eligibility verification