Insurance verification should always be high on your practice’s list of priorities. Quality front desk staff adequately trained in insurance verification is worth the investment. The verification process is the first and most significant medical billing and coding step. Due to the always changing and increasingly complex healthcare environment, you will need to pay close attention to validating coverage, benefits, co-payments, and deductibles. The attention required to verification is crucial, and medical care providers must understand the insurance verification process and its importance in the healthcare industry.

Here are some tips to focus on when performing insurance verification:

• A complete patient demographic record is critical to the insurance verification process.
• Health insurance verification is the process of checking a patient’s active coverage with the insurance company.
• Beware of typos in Member ID numbers and Group numbers – this will help avoid rejections. 
• Many software systems, such as Athena, can automate the eligibility process by integrating with systems of major payers to batch-check scheduled patients in real-time. 
• It is essential to properly archive previous insurance information in the software system with valid expiration dates and to include the start date of the updated insurance policy. 
• Proper selection of Insurance Carriers in the software system is imperative to the claim being sent to the appropriate electronic payer ID/address. i.e., Aetna: Aetna PPO, Aetna Medicare Replacement, Aetna Better Health, and so on. 
• Insurance verification minimizes denied claims. Save your denial management team time!
• Establishing a standard operating procedure for your front desk staff is essential – reach out to us for help!

Please take a moment to answer the survey below to get a snapshot of where your practice is with its SOPs and training.