How to Complete a GREAT Insurance Verification!
There are a few different ways to do an insurance verification. The best way for you will depend on your practice's specific needs and preferences.
Here are some options:
There are a few different ways to do an insurance verification. The best way for you will depend on your practice's specific needs and preferences.
Here are some options:
- Use the Insurance Carriers preferred portal. Most Insurance carriers have a direct or preferred portal they work with to provide detailed benefits to the office. These tools can help you to quickly and easily verify a patient's coverage, and they can also help you to determine the patient's out-of-pocket costs. They work great for a quick overview of benefits.
- Call the insurance company directly. You can also call the insurance company directly to verify a patient's coverage. This can be a bit more time-consuming, but it can also be more accurate than looking up on a portal. Calling an insurance company also allows you to ask about specific CPT codes versus general medical benefits.
- Use an insurance verification service. There are a number of companies that offer insurance verification services. These services can help you to quickly and easily verify a patient's insurance coverage. At Bushido, we call the insurance directly for every verification and ask about specific benefits for every CPT code the office would like to use.
No matter which method you choose, it is important to make sure that you are verifying the patient's insurance coverage before you provide any services. This will help to ensure that you are getting paid for the services you provide, and it will also help to avoid any surprises for the patient.
Here are some additional tips for calling on an insurance verification:
- Gather all of the necessary information. Before you call the insurance company, you will need to gather all of the necessary information, such as the patient's name, date of birth, and insurance identification number.
- Be clear about the services you will be providing. When you call the insurance company, be clear about the services you will be providing. Most times you can even ask about specific CPT codes instead of general services. This will help the insurance company to determine if the services are covered under the patient's plan as well as distinguish if there are different benefits for different services such as an office exam versus treatment.
- Ask about ALL possible payment coverages. Be sure to ask about any deductibles, copays, coinsurance, visit limits and out of pocket maximums that the patient may be responsible for. This will help to avoid any surprises for the patient when they receive their bill. We also recommend asking about possible authorizations needed for any services and how you can most easily obtain those.
- Document the insurance verification. Once you have completed the insurance verification, be sure to document the information including whom you spoke with, the date and a call reference number. This will help to ensure that you have a record of the patient's coverage in case there are any problems with the claim.
It’s important to note that a verification of benefits is not a guarantee of payment or coverage as all charges are subject to the plan guidelines upon submission of a claim. But by following these tips, you can help to ensure that you are doing insurance verifications as accurately as possible for your patients.
If you’ve read this far, and still have questions relating to Insurance Verifications (or you just want someone with expertise to help you work through yours) do not hesitate to reach out! We are a team of billing experts that love to help others improve their business and increase cash flow. Check us out and schedule a free discovery call at www.bushidobilling.com to see if we might be the right fit for you!
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