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Importance Of Insurance Verification In Healthcare

Insurance verification services help healthcare providers plan the payment process

. Provided by established medical billing companies, these services help group and specialty practices and hospitals understand what patients owe them. They are also designed to help providers confirm whether the medical procedures recommended are covered by the insurer or not.

Health insurance verification is all about the process of checking a patients active coverage with the insurance company and verifying the eligibility of his or her insurance claims. To avoid claim rejection, this process should be carried out before the patient is admitted into a hospital. The service includes verification of: payable benefits, co-pays, co-insurances, deductibles, patient policy status, effective date, type of plan and coverage details, plan exclusions, claims mailing address, referrals & pre-authorizations, life time maximum, and more.

Medical insurance verification is a time-consuming and tedious task for most healthcare providers. Due to the enormity of their core responsibilities, most of the medical professionals do not have enough time to carry out eligibility verification. Also, healthcare practices do not have much idea about the technical aspects of submitting claims. Non-verification of insurance eligibility may lead to problems such as delayed payments, rework, increased errors and patient dissatisfaction. All this underlines the importance of insurance verification in healthcare.

Comprehensive insurance benefit verification


Outsourcing insurance verification services to a medical billing company can be extremely helpful for those professionals who dont have time to spare on this task. Medical billing outsourcing firm can get your claims checked, billed and processed accurately. Insurance verification process includes:

Receiving patient schedules from the hospital via EDI, email or fax

Verifying patients insurance coverage

Contacting patients for additional information

Updating the billing system with eligibility and verification details such as coverage start and end dates, member ID, group ID, co-pay information and much more.

Obtaining insurance verification services from medical billing firms offers a wide range of advantages for the healthcare provider. Hiring an insurance authorization specialist will help you to avoid the hassles involved in insurance eligibility verification. Apart from saving time, there are many other factors that make outsourcing health insurance verification important for healthcare providers. Listed here are some of the benefits of outsourcing this task:

Reduces your risk factors

Simplified workflow

Fewer claim rejections

Faster billing cycles

Minimize delays considerably

Reduced number of returned claims

Improve payment and collections

Speed up approval and authorization


Maximizes office efficiency and economies of scale

Reduced possibility of claim rework

Successful medical billing depends on successful insurance verification services. Healthcare facilities should give primary importance to such verification to reduce claim denial and maximize reimbursement.

by: mososi
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Importance Of Insurance Verification In Healthcare