Insurance eligibility verification is important for all medical practices or else they will end up with unpaid claims by the insurance company. In a worst case scenario, they might never get paid for the rendered services. Since all medical practices run on money, it is very important to ensure consistent cash flow without claim rejections. This is possible only when medical billing is done successfully and for billing, accurate insurance verification is important.
Why is eligibility verification necessary?
Insurance eligibility verification is the first and most important step in the medical billing procedure. If the insurance coverage information provided by patients during visits is incorrect or inadequate or if the current coverage information isn’t updated by the practice, then it will lead to claim denials or delays in payment.
If you run a medical practice and you don’t ensure adequate eligibility check, you will become prone to not getting paid for insurance claims. Timely verification will help in establishing the payer’s responsibility. It will also give you a better picture of the patient’s coverage, benefits, insurance information and so on. The possibilities of claim denials, categorical rejections and re-submissions will also end.
It is very important for providers to ensure that patients are aware of their insurance status. Since insurance protocols keep changing, it is necessary that they are also updated with the changes. Even the provider and their medical billers need to verify if the patient is covered under the new plan so that they can obtain maximum reimbursement. Doing this will help avoid reworks, errors, patient dissatisfaction and other factors that can cause delays or denials.
Outsourcing eligibility verification to boost revenue
It helps to let a third party handle eligibility verification task. With outsourcing, providers can not only increase revenue and minimize delays and denials but also boost collections through reduction in write-offs.
A reliable medical billing company starts by receiving schedules of patients via email, fax or other mediums or check them daily in the appointment scheduling software. They verify the patient’s insurance coverage with primary as well as secondary payers either by calling the payers or checking through online insurance portals. Companies also contact patients directly for additional data. The next step involves updation of the billing system with verification details. The provider is informed in case there is any issue regarding a patient’s eligibility.