How Important Is Insurance Eligibility Verification?

Posted by Deepak Sanghi on October 6th, 2017

Insurance Eligibility Verification is one of the most important steps in the entire medical billing cycle, and it is significant for healthcare providers and billing companies to understand the crucial role it plays in the industry. This process looks into the insurance coverage and eligibility of a patient. This process must be done carefully and accurately to avoid insurance coverage apprehensions, billing errors, and long waiting periods. It should be done even before admitting the patient into the facility to prevent claim denials down the road. Successful billing starts with efficient Insurance eligibility verification.

Did you know that more than half of denied or postponed claims are due to incorrect or outdated information provided by the patients, or due to the termination or modification of their policies? Insurance eligibility verification must be done correctly because even a seemingly simple mistake can lead to a claim being rejected or denied—which means that the patient won’t get the care he or she deserves.

A health insurance verifier or insurance verification specialist plays a huge part in the health insurance system. They deal with patients, accomplish paperwork, and liaise with the insurance carrier to verify the following: 

-          Co-pays

-          Co-insurances

-          Payable benefits

-          Deductibles

-          Type of plan and coverage

-          Effective date

-          Patient policy status

-          Plan exclusions

-          Annual & Lifetime maximum

-          Referrals and pre-authorizations

-          Claims mailing address etc.

An efficient and effective insurance eligibility verification process helps maximize reimbursement and improve the revenue cycle of a hospital, clinic, or practice. However, a good system involves many moving parts and steps, including receiving the schedules of the patient from the practice, verifying their insurance coverage, contacting the patients for more information, and keeping the billing system updated, among others.   

Because managing the tasks involved in insurance eligibility verification can be quite stressful and time-consuming, it often makes more sense to outsource verification services to an expert provider. A reliable offshore medical billing company will be able to help you significantly reduce the effort and time you need to spend on processing claims and billing. They have the systems and the people in place to speed up authorization and approval of your claims, ultimately simplifying the workflow, reducing operational costs, and improving your facility’s productivity.

About E-care India:

E-care India is one of the pioneering offshore medical billing companies based in India that promises to avoid the risks involved with missed Charges. With 17 years of experience in the industry, e-care’s 3 delivery centers have been providing end-to-end medical billing services flawlessly to its clients. To know more about e-care and its services, log on to www.ecareindia.comor call at 813-666-0028.