Insurance Verification and Eligibility Services Benefit Healthcare Facilities

by | Last updated Jul 4, 2023 | Published on Aug 20, 2011 | Insurance Verification and Authorizations

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Insurance verification services play a key role in a healthcare facility’s claims denial management program. Successful insurance eligibility verification is necessary for successful medical billing. Most of the healthcare professionals do not have enough time to learn about the process and their staff may not have the time to carry out the insurance verification process efficiently. This often leads to a situation where you don’t receive due payment for services provided.
By hiring insurance verification services from a reliable outsourcing company, you benefit from the service of insurance eligibility verification specialists who are proficient enough to offer the best of services. You don’t have to worry anymore about claim denials. Professionals in these companies will check for continuously changing policies and take care of the entire health insurance verification process and verify patient information with the insurance provider, all the while focusing on maximizing your collections.

Insurance Verification Process: Insurance eligibility verification process involves many steps.

  • Receiving patient schedules from hospitals or clinics via FTP, email or fax
  • Verifying patients’ insurance coverage on all primary and secondary (if applicable) payers
  • Verifying demographic information
  • Updating patient accounts
  • Contacting patients for additional information if necessary
  • Updating the billing system with eligibility and benefits information such as member ID, group ID, coverage start and end dates, co-pay information and much more.

By outsourcing insurance verification requirements, healthcare facilities can gain a wide range of benefits. Listed here are some of the advantages of outsourcing insurance verification services.

  • Reduced effort and time
  • Fewer claim rejections
  • Speed up approval and authorization
  • Simplified workflow
  • Increased number of clean claims
  • Faster billing cycles
  • Improved staff productivity
  • Reduced rework of claims
  • Improved cash flow and better collections
  • Maximize office efficiencies and economies of scale
  • Boost revenue
  • Reduce capital costs
  • Expand company focus
  • Improved staff productivity
  • Devote more time to core business objectives
  • Save 30 to 40% of your insurance verification operational costs
  • Increased upfront collections

Outsourcing insurance verification process is a time and cost saver option for various healthcare practices. Today, there are several outsourcing companies that help practices significantly increase their revenue by providing insurance verification and eligibility services. They have a team of professionals who work with patients as well as providers to verify medical insurance coverage and generate claims for services rendered. They also provide full support to obtain pre- authorization number, referral from PCP, and more.

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