Insurance Verification

Insurance verification is the first and most significant step in the medical billing and coding process.

In today’s continually changing and increasingly complex healthcare environment it requires, more than ever, close attention to validating coverage, benefits, co-payments, and deductibles. Failure to do so could leave your practice with an unpaid claim from the insurance company or a patient saddled with unexpected expensive bills. Proper insurance verification and pre-authorization enable faster and more efficient payments, reduced debts, and enhanced patient satisfaction.

cash flow paperwork

Improves Cash Flow

Accurate insurance verification ensures a higher number of clean claims which speeds up approval and results in a faster billing cycle. Inadequate verification of eligibility and plan-specific benefits puts healthcare organizations at risk for claim rejections, denials, and bad debt.
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paper work being approved with stamp that say approved

Minimizes Claim Rejections and Denials

Verifying the insurance coverage in advance, results in fewer claims being denied. Since insurance information changes frequently, failure to stay ahead of ever-changing regulatory requirements could lead to rejected claims, billing errors, and reimbursement delays. Hearing Healthcare providers need to be vigilant and verify the member’s eligibility every time before the services are provided.
Happy doctor and patient shaking hands

Increases Patient Satisfaction

Nine in ten consumers want to know their payment responsibility upfront. It is important to contact the patient’s insurance carrier prior to their visit and services being rendered to ensure they are included in the patient’s health insurance coverage. Errors in carrying out efficient insurance verification or submitting a claim for services that the patient’s insurance carrier does not cover or are delivered by Providers who are outside the employee’s health insurance provider network will leave the patient financially exposed, fearful, and frustrated. As a result, the patient will have to pay 100% for the services. This isn’t just bad for patients, but detrimental to your practice as well.

Do you face high denials? Do you know the right questions to ask to get the answers the FIRST TIME? - Don’t worry, we do, and we are here to help.

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