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5 Steps to Verify Patient Insurance as the New Year Begins

Posted by 99 MGMT on Dec 20, 2019 8:01:06 AM

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Check All the Boxes During the Initial Information Transfer

The initial transfer of information from patient to practice is extremely important. This is your opportunity to obtain a broad and detailed scope of a patient’s insurance coverage to enter into your system.

The most crucial tip when collecting this information is to be as thorough as possible. Though most people typically don’t like to fill out lots of forms, making sure that patients take the time to provide this information now will save them - and you - time and hassle later on.

Here are the primary pieces of information to ensure you collect during the initial patient information transfer:

  • Insurance name, phone number, and claims address
  • Insurance ID and group number
  • Name of insured (be careful - this isn't always the patient)
  • Relationship of the insured to the patient (if applicable)
  • Policy effective date
  • Policy end date, if available
  • If the insurance covers the procedure, diagnosis, or services to be provided
  • If your practice participates with the plan
  • Limitations of the policy (exclusions or documentation requirements for bills, etc.)
  • Whether a referral or certificate of medical necessity is required for payment
  • Amount of the patient's copay, deductible, and co-insurance

 

Make a Copy of the Insurance Card

Getting a copy of the patient’s insurance card is one of the smartest things you can do for your practice. Human error is possible, as much as we’d like to hope it doesn’t happen. If you scan an insurance card, you have a way to back up the information you type into the system, just in case something was entered incorrectly.

Additionally, this is also beneficial in the event that the insurance company needs to verify any policy numbers or names.

 

Verify Patient Information with the Insurance Company

As stated before, verifying patient information with their insurance company is crucial. By doing this, you get the opportunity to ensure that their policy is still active and current.

Also, some EHR systems allow for electronic eligibility verification systems that will automatically verify eligibility upon entry into the system. These are more efficient and will save you time in the input process.

 

Take Extra Care to Record Accurate Patient Information

Trying to hurry through the process of verifying patient information is bad news. Doing this can lead to input mistakes that end up making a mess of payments for the insurance company and for the patient. 

Ensuring that you take enough time to thoroughly double check and run through all of the patient’s data before submitting it will save time and grief down the road.

 

Follow Up with Patients Consistently

Finally, it is important to make sure you’re consistently double checking patients’ information each time they visit your practice. 

Whether it is an address change that could result in a billing error, or a change in coverage based on the patient’s employee benefits, it’s crucial to clarify whether or not any changes have happened since their last visit that could affect their insurance coverage.



Ultimately, insurance data input is one of the most important aspects of a patient’s experience with your practice - so making sure this information is correct is vital. 

There are dire consequences for mistakes in this area, so make sure to constantly take the time to ensure you have accurate and current information so you can provide the best possible patient experience.

Topics: Operations, Enrollment, Practice Management, Financial, Medical Billing