Health Reform Will Spur Demand for Insurance Benefit Verification Services

by | Last updated Dec 7, 2023 | Published on Jan 7, 2013 | Insurance Verification and Authorizations

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Starting 2014, almost all Americans will be required to have health coverage or pay a fine. The year will also see the setting up state health insurance exchanges where individuals and employers can shop for affordable health insurance plans. According to projections by the Congressional Budget Office, the single biggest impact of the exchanges is likely to be greater access to healthcare, with 8.9 million individuals expected to sign up in the first year alone.

With more people enrolling in health plans, physicians’ offices are going to be busier places. Even in the current healthcare scenario, doctors are struggling to maintain balance between patient care and practice administration such as maintaining accurate medical records, organizing them and dealing with medical claims processing. A lot of doctors do not get paid properly for services they provide due faulty claim submission process and lack of proper benefit verification. This results in claim denials and causes delays that severely affect their overall productivity.

Many claim denials occur when insurance eligibility fails is not properly verified. Physician office staff is often too busy with other tasks and do not find the time to verify the benefit details of each and every patient. This pitfall can be avoided by approaching an established medical billing company which offers end-to-end insurance benefit verification solutions. The process of medical insurance benefit verification starts with verification of the patient’s active medical coverage, receiving patient schedules, updating verification and eligibility details in billing system. and contacting patients for missing information, if necessary. The main benefits that insurance verification services offer are:

  • Submission of clean claims
  • Minimal claims rework
  • Fewer claim rejections
  • Reduced operational costs (30 to 40%)
  • Enhanced revenue

A reliable medical billing service provider would have a team of skilled and experienced medical benefits verification specialists who provide this essential billing and settlement support. They work with patients and medical facility personnel to gather the necessary information. Information collected and checked during the health insurance verification process would relate to co-pays, co-insurances, deductible account, effective date, and active or inactive patient policy status, and more.

All important insurance eligibility verification work for all scheduled appointments will be completed on time, before the patient appointment date. This seamless service allows physicians to devote more of their time to core patient care activities, more important as they can now expect an increase in the number of patients with more people enrolling in health insurance plans.

  • Natalie Tornese
    Natalie Tornese
    CPC: Director of Revenue Cycle Management

    Natalie joined MOS’ Revenue Cycle Management Division in October 2011. She brings twenty five years of hands on management experience to the company.

  • Meghann Drella
    Meghann Drella
    CPC: Senior Solutions Manager: Practice and RCM

    Meghann joined MOS’ Revenue Cycle Management Division in February of 2013. She is CPC certified with the American Academy of Professional Coders (AAPC).

  • Amber Darst
    Amber Darst
    Solutions Manager: Practice and RCM

    Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS.

  • Loralee Kapp
    Loralee Kapp
    Solutions Manager: Practice and RCM

    Loralee joined MOS’ Revenue Cycle Management Division in October 2021. She has over five years of experience in medical coding and Health Information Management practices.