Why is the verification of benefits essential when it comes to medical claims? Successful billing and coding depend greatly on health insurance eligibility verification that’s both complete and prompt. Healthcare providers who want to improve internal processes and provide better care for patients should then prioritize this. Healthcare providers could face massive losses when claims are denied despite patients being initially deemed covered. The eligibility of every patient’s insurance claim needs to be adequately checked to ensure that the patient can afford the planned treatments with their health insurance coverage.
What Are Examples of Health Insurance Benefits?
Health insurance is one of the most important purchases any person can make. It’s essential to thoroughly understand the possible benefits of health insurance that your patients may take advantage of while in your care. These health insurance benefits include:
- Cashless hospitalization- Many insurers have a list or network of hospitals they’re partnered with all over the country. If a patient gets admitted into a healthcare facility that’s in-network, they will most likely be able to take advantage of the benefit of cashless hospitalization. This eliminates the claim reimbursement process because the insurer directly pays medical bills to the in-network facility.
- Financial protection- The truth is that the most significant benefit of purchasing health insurance is that having it can prevent the depletion of a patient’s long-term savings. The rising costs of quality healthcare can make finances very unpredictable, especially if someone is not as healthy as they can be. Having health insurance means that having one accident or finding out about a new health problem won’t create unmanageable debt.
How Can You Begin Verifying Insurance Benefits?
When it comes to verifying insurance benefits, you need access to many details, including the differences between insurance providers, their network affiliations, the types of coverage they offer, and more. Fortunately, gathering the needed information can be a fairly straightforward task.
You’ll need to follow certain steps when verifying insurance benefits for your patients. Some of these steps include:
- Look at their insurance cards- These cards provide phone numbers or other ways to contact representatives of the insurance companies involved. These representatives can give you a summary of a patient’s health plan benefits. Insurances may also have benefits and eligibility numbers printed directly on them, along with the addresses where you can send medical claims. It will also usually have the logos for the networks to which the insurer belongs.
- Contact the insurers or their networks- Your first call will probably be to the insurer, as mentioned above, as they can verify plan benefits concerning in-network or out-of-network coverage. The insurer may also advise you about any applicable co-pays, coinsurance responsibilities, and remaining deductibles. If you have any doubt about coverage details, you can contact the insurer’s network and verify that the insurer does participate in the network.
Handling Verifying Health Insurance Benefits In-House or Outsourcing: What’s More Efficient?
Without the proper practices and systems in place, healthcare providers could face massive losses when claims are denied or delayed despite theirs patients initially being deemed covered by their individual insurance plans. Efficiency when handling this process is paramount.
If you’re experiencing problems when handling the verification of patients’ insurance benefits, it could be because your in-house staff lacks the experience to do a better job. It could also be that your medical billing and coding department is too small to handle their normally received workload. It would be best to consider outsourcing the work and depending on professional companies that can handle medical billing and coding with expertise.
Choose CodeMax Medical Billing for Help with Verifying Insurance Benefits
When you are ready for professional help in verifying the health insurance benefits of your patients, reach out to CodeMax Medical Billing by calling 866.471.3267 or filling out our online contact form.