Collect More Accurately with Eligibility and Benefits Verification

1. Collect More Accurately with Eligibility and Benefits Verification Medical Billers and Coders

2. Eligibility and benefits verification is the first and most significant step in the medical billing and coding process. Today’s continually changing and increasingly complex healthcare environment requires, more than ever, close attention to validating coverage, benefits, co-payments, and unpaid deductibles. With the eligibility and benefits verification process in place, you can collect more accurately. Thus, it becomes crucial that providers understand the insurance verification process and its importance in the healthcare industry. 

3. Completing eligibility and benefits verification prior to appointment, for procedures or equipment, results in fewer claims being denied. Since insurance information change frequently, failure to stay ahead of ever-changing regulatory requirements could lead to rejected claims, billing errors, and reimbursement delays. 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. It is important to contact the patient’s insurance carrier prior to the procedure or services being rendered and ensure that it is included in the patient’s health insurance coverage. Errors in carrying out efficient insurance verification or submitting a claim for a procedure that the patient’s insurance carrier does not cover, or is 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 percent for the services.

4. You can perform eligibility checks several different ways, depending on the processes your office and insurance carrier use. You can verify patient information by checking the website of the insurance carrier or by calling a representative directly. Some practice management software and clearinghouses also can check patient eligibility for you, saving staff time and effort. A primary care provider generally wants to confirm that insurance is in effect at the time of service and figure outpatient responsibility portion. A specialist, however, needs to check if the co-pay for a specialist visit differs from the co-pay for a primary care visit. A specialist also needs to verify if their services will need a referral or pre-authorization.

5. Email : info@medicalbillersandcoders.com Fax no: 888-316-4566 Toll Free no: 888-357-3226 AddressWilmington, 108 West, 13th street, Wilmington, DE 19801Texas, 539 W. Commerce St #1482 Dallas, TX 75208