Medical billing services hold a paramount position in the healthcare landscape. Mainly, they help healthcare providers get proper compensation for rendered services. People usually get confused about the medical billing process. They merely consider the coding and charge submission as part of the whole process. But it is not true. It consists of a detailed documentation process usually starting from the patient insurance eligibility check. Then, it continues after the claim submission to check the claim status until complete AR recovery. And the process elongates if the claim faces denial by any chance. Then the medical billing services have to go the extra mile in the form of denial management. So, the medical billing process begins as the patient reaches the facility’s front desk or calls for an appointment.
Every time a patient comes to the hospital, the front office staff attends to them. The first thing the staff immediately does at this time is insurance eligibility verification. Although, due to mismanagement or a poor internal system, we often overlook this step. However, it is a very crucial step for excellent healthcare billing services.
In this blog, we will especially focus on the importance of insurance eligibility verification. But before moving ahead, let’s uncover the process of patient benefit verification for understanding. Later, we’ll unfold the benefits of eligibility verification and the necessity of the process.
Understanding Medical Insurance Eligibility Verification
Medical benefit verification, or verification of benefits, is another term for insurance eligibility verification. During this process, the front desk person notifies patients about their insurance coverage.
This verification just before providing healthcare services is necessary. Otherwise, they will be out-of-pocket if they are charged for any out-of-network service. Not only this, but the person also verifies the patient’s demographics and policy details. This will simply help in the elimination of any sort of errors during charge submission.
How Does a Patient’s Benefits Verification Work?
Here we have mentioned the steps included in the usual process of patient benefit verification:
Patient Data Collection
It involves the collection of patient demographics. For instance, name, date of birth, insurance provider, policy number, group number, etc.
Connecting the Insurance Providers
In the next stage, we verify the patient’s insurance details. The medical attendant gets an insurance number and then confirms the rest of the information electronically. They may include verification of their policy status and benefits.
Communicating with Patients
Then, patients get information about their out-of-pocket expenses, if any, before initiating treatment.
Updating Records
The information thus entered in the patient’s electronic health records Providers can easily access this information for future use. Medical billing providers also have access to this information.
Now, check out the key benefits we get from implementing insurance eligibility verification.
Key Benefits of Health Insurance Eligibility Verification
The financial health of a practice matters a lot for its sustainability. The medical billing services take responsibility for securing it. They ensure successful claim processing. However, the primary process that guarantees the overall success of the process is insurance verification. Listed below are some of the major benefits of insurance benefit verification:
Lesser Billing Errors
The right verification process reduces the chance of any incorrect medical billing. Thus, it prevents disputes and delays in revenue collection.
Cost Savings
Patients avoid unexpected expenses with a fine understanding of their coverage limits beforehand.
Improved Patient Experience
Patient benefit verification assures smooth claim processing and submission. Overall, it enhances patient satisfaction.
Efficient Revenue Cycle
Along with that, it simplifies and streamlines the billing process. Providers experience less administrative burden.
Minimization of Denied Claims
In medical billing, benefit verification lowers the possibility of claim denials because of problems with coverage.
Wrap Up
To conclude, the necessity of insurance eligibility and benefit verification can’t be denied. It is one of the fundamentals of the medical billing process. Benefits verification equally benefits both the patients and their respective providers. It is necessary for denial reduction, improved financial security, and fewer billing errors. Simply put, it helps practices score better financial outcomes.
FAQs
What is eligibility insurance verification?
It is the process of determining whether or not a patient’s insurance plan covers their medical services.
How many insurance benefits can be confirmed?
Contact the insurance provider. Then, inquire about the patient’s policy specifics and coverage to confirm insurance benefits.
Who can vouch for my patients’ benefits?
Your front desk employees or the company that handles your medical billing can verify your patients’ insurance coverage.
