Insurance verification functions as a catalyst to make the reimbursement process quick and hassle-free. It is the responsibility of the insurance verification specialist to determine the insurance claims as true or false. To determine the true nature of the insurance claims made by thousands of patients the verification specialist must pay attention to the following tips.
Follow the Steps Closely: Medical Insurance Verification Services is a multi-step process and requires a lot of patience to make the process successful. So, the most promising tip to avoid any denied claims or fraud is to follow all the steps closely. There are seven steps involved in the insurance verification process— patient scheduling, patient record, eligibility and verification, pre-approval or authorization, contacting the patient, updating the medical billing system and claims transmission. Each step is imperative to determine the true nature of insurance claims. Therefore, one must not skip any step as it may decrease the chances of maximum reimbursement resulting in a financial loss to the hospital.
Double-check Patient’s Demographic Details: Sometimes, insurance verification specialists tend to overlook the patient’s demographic detail thinking they are bound to be right. However, patients with false claims are likely to give false demographic details to hide their true identity. Such cases lead to insurance fraud affecting the hospital’s revenue cycle. Therefore, the verification specialist must double-check the patient’s demographic details. If possible a thorough background check may prevent insurance fraud at the earliest.
Ask for a Patient’s Insurance Card: Always, ensure to ask the patient for his/her insurance card details. Make sure to keep a copy of the same for future reference, Mistype insurance number may lead to the denial of an insurance claim.
Contact the Insurance Payer: The insurance payer must contact the insurance company as soon as he/she gets the details of the patients’ insurance claim. It’s a good idea to stay in touch with the insurance payer either via call or email. If required the insurance specialist may visit the insurance payer’s office.
Avoid Making Errors: While typing the details in the medical billing system, it is important to type all the details correctly. There’s no room for error for a minor mistake may result in denied claims or fraud.
Follow Up with Patient: Keep the patient updated about any change or discrepancy in the insurance claim.
