This article discusses the importance of Insurance Verification and Authorization for medical practice revenue. Medical practices that lack an effective system for insurance authorization risk lost revenue and reduced patient satisfaction.
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| The Importance of Insurance Verification | Avoid Unpaid Medical Bills | Scheduling the Appointment | Coverage and Benefits | Authorization Vs. Verification |
The Importance of Insurance Verification
Insurance can often be a nuisance for medical practices and their practitioners. Administrators and physicians often face confusion when trying to comply with insurance requirements for patient coverage. The first step to understanding how to ensure proper payment from insurance companies is learning the importance of patient insurance verification. Insurance verification is the process of confirming a patient's insurance benefits, and insurance authorization permits payment for a specific treatment or service. Failing to verify insurance before an appointment with a new patient can lead to unpaid medical bills and decreased revenue overall.
Avoid Unpaid Medical Bills
Medical practices must verify insurance each time a patient visits the office regardless of whether they are new. If a patient's insurance changes from their last visit, that information must be updated and verified. Furthermore, office staff must spend valuable time tracking down patients to gather correct information or payment in this instance. Billing to obsolete insurance policies results in unpaid medical bills and lost revenue.
There are multiple steps to ensuring health insurance verification is done properly. Below is a list of fundamental steps to understanding insurance verification and authorization.
1) Scheduling the appointment:
Patients schedule an appointment at a clinic or with a physician. Scheduling can be done via an online software that allows self-scheduling, such as Setter, a proprietary software from XAmplifier. Software systems like Setter allow patients to input their insurance information for a streamlined verification process. Or appointments can be made with staff over the phone, and insurance information can be manually recorded during the phone call.
2) Coverage and Benefits
Once the patient's identity is confirmed, and their information is added to a given database, the hard part starts. Contacting insurance companies can be challenging and often time-consuming for staff. Many practices find investing in insurance verification services helpful, especially if they are low on staff.
3) Authorization Vs. Verification
Authorization of a specific service or treatment is necessary to ensure payment from an insurance provider. Authorization from an insurance company is a legally binding agreement of payment. Verification only ensures that a claim can be made on behalf of the patient, but not that coverage is guaranteed.
Verifying patient coverage and the authorization of services is crucial for revenue overtime. Having an effective system in place reduces person-hours associated with tracking down patients to update their information or collect payments. Medical practices struggling with the insurance verification process should invest in services and software to ease the administrative burden of patient data intake.
Please fill out this form to learn more about how XAmplifier can improve your insurance verification process.
