Medical Office Billing: Benefits Verification, Copayment and Consolidated Billing
Is Lack of Verification Costing Your Practice? Stop the Bleeding
Implement an eligibility check before the patient comes into your office
Verifying insurance coverage and benefits eligibility consumes precious time and resources in a practice. When a third-party payer keeps your staff on hold for inordinate amounts of time, you may start wondering whether you should take time to verify at all. But if you don’t check and confirm each patient’s insurance coverage, you could be costing the practice much more time and money on the back end from denied claims and lost copayments.
By checking a patient’s insurance eligibility, you prevent not only claim denials but also payment delays that arise when patient insurance information doesn’t match up with the carrier’s.
Don’t worry: If you set up a solid, streamlined process, insurance verification will become second nature. Follow these expert tips and get your practice on the right track.
Step 1: Verify As Soon As Possible
The first question about insurance verification that many practices wrestle with is when they should perform the eligibility check — before the patient comes in, at check-in, while the patient is with the physician, or after the appointment.
Best bet: “In an ideal world, it should happen before the patient is treated,” says Laura Colbert Carbonaro, director of central billing operations for ENT and Allergy Associates in Tarrytown, N.Y. “There is no need to ‘verify’ eligibility after the services are rendered and the patient has left the office. Your options to collect payment are already diminished. At that point, why waste time calling to find out whether or not your gamble paid off?”
Bonus: “If you verify it before the patient walks through the door, you can be sure you have...
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