Turn Rejections into Reimbursements with Accurate Patient Insurance Verification

Healthcare providers today are faced with challenges in preparing claims with reliable information. They may receive patient information from a stale database, leading to claim rejections. This causes rework on the provider to find, correct and resubmit the claim again. By utilizing accurate patient insurance verification prior to claim submission, you can prevent these rejections and cut costs from manual rework. 

Benefits of Accurate Patient Insurance Verification

1. Improved Cash Flow

If you have the correct insurance information on your patients up front, this will help your cash flow by reducing the number of rejections and denied claims. Fewer claims being turned down translates to more claims being accepted, which means more money faster.

2. Minimizes Claim Rejections and Denials

As a provider, you may assume that a patient's insurance information from last year is still current. That claim will be sent to the wrong company if their insurance has changed. This means the claim is rejected right away, and you will need to contact the patient to find the correct insurer and resubmit the claim. You've already spent more time and money on that first claim. By accurately identifying the patient and their insurance the first time, this rejection could have been avoided.

3. Increases Patient Satisfaction

We've all been in a situation where we went to the doctor for treatment but paid much more than we thought we would. Your insurance should have paid for the whole thing, right? As a provider, you can prevent this from happening. One way is by verifying the patient's insurance prior to their appointment and letting them know what their plan covers. Thus, patients won't be surprised by any extra costs.

What is The Difference Between an Insurance Authorization and Insurance Verification?

Insurance verification verifies a patient's insurance information is correct. Insurance authorization is getting an insurer's permission to provide certain services. The process of making and sending medical claims differs from this. It's not a motion to get paid after the fact but a way to approve services.

If your patient needs specific treatments, prescriptions, or tests, you may need to get permission from their insurance company. Different payers have different rules about when authorization is required. Still, in general, their goal is to ensure that payer money goes toward essential services of high quality.

Wrapping Up

Accurate patient eligibility verification is crucial for healthcare providers since it affects the time it takes to receive reimbursement for their services. Another advantage of validating coverage in advance is that it gives providers and patients an accurate estimate of the patient's financial responsibility. So, if patients know this ahead of time, i.e., before their appointments, they will be ready to pay. This eliminates any possibility of misinterpretation.

For more information on how to accurately verify patient insurance information, request a discussion with an expert today.