How Medical Insurance Eligibility and Verification Services Help in Improving Denials

Every Company’s main aim is to have profits and for that, a smooth and streamlined process flow is very important. One of the core task involved in Medical Billing process is Insurance eligibility and its verification. The validation is very important to avoid any consequences and risks at a later stage. The Medical billing companies can help to avoid denials or delays which is useful for your practice. Therefore, every claim should undergo a verification process irrespective of any medical plan.

Let us see how verification can improve the denials in medical billing process:

  • To avoid denials, the Medical Billing Companies should verify the date as compared to the expiry date of insurance coverage mentioned.
  • There are some cases wherein the patient goes for his secondary insurance for the claim due to the expiry of the primary insurance. This should be checked otherwise the claim would be rejected.
  • The practinoner should first get information regarding patient’s insurance premium payment because if the patient would not have paid premium then the insurance may have been expired and the claim would be denied.
  • Patients do have multiple insurance plans under their name or family‘s name so it becomes very important to verify the insurance so as to not mistake any other plan while claiming.
  • There are few of the insurance carriers who accept the claim only if it is given by the name of qualified practioner which makes insurance validation mandatory.
  • The verification process also checks if there are any deductibles in the insurance claim of the payment, which can only be known via verification process.
  • There are stated diseases under Insurance plans of the company for which only claims would be accepted which need to be checked before processing the claim.
  • Insurance carriers have patient visit limits and if it exceeds then they deny the claim covered under the plan.

Thus, above stated points clarify that to curb the errors and reduce the losses, it is better to have insurance eligibility and verification done. It speeds up the process as the claims will not be denied and need not need to have it follow up. This assures that claims will be accepted as it smoothly goes through insurance verification process. The medical billing outsourcing companies handles these quite well and therefore, there are less number of denials and immense profit to your practice.

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