Verifying patients’ insurance before an appointment or procedure is one of the most critical aspects of your medical or dental practice’s billing procedures. It is no secret that insurance companies change their policies all the time, and any mistakes could lead to rejection of payment.

One of the hallmarks of a thriving medical practice or dental practice is on-time processing and receipt of payments, which maintains your bottom line. Let’s talk about how insurance verification works and what the process looks like.

Insurance Verification with the Patient

It’s imperative to collect the patient’s insurance information when you are actually setting up an appointment with the patient. That way, if there are any issues, your staff member can call the patient back before the appointment even occurs.

The first step is to collect the following information when the patient calls to make a medical or dental appointment:

• Patient’s name
• Patient’s date of birth
• Name, telephone number, and address of the insurance company
• Name of the primary insurance plan holder, and the relationship of the patient to the primary holder (if it is someone else in the family)
• Patient’s policy number and group ID (if applicable)
• Secondary insurance (if applicable)

Verifying Coverage with the Insurance Company

Insurance verification starts with verifying the patient’s eligibility and active benefits for medical billing purposes. The staff member needs to check whether the patient’s insurance information is accurate, and that entails contacting the patient’s insurance company even before the patient’s date of appointment.

As the staff member speaks with a representative from the patient’s insurance provider, the staff member may go through a checklist of questions, such as:

• Patient’s name, age, and address
• Insurance policy number and whether it is active
• Coverage limitations
• Patient copay information
• Patient deductible

The answers to these questions will help the staff member determine whether the patient has a valid insurance policy, what the cost of the visit will be, and whether the appointment should possibly be postponed in order to ensure coverage. Some policies have frequency limitations of regular checkup-style appointments, such as every six months and no sooner.

Since dental insurance and medical insurance policies often change annually, and patients’ lives also undergo changes that affect their insurance policies, it’s important to stay updated and to reverify the patient’s insurance policy each time – even for longstanding patients.

Billing Insurance Verification Service in Cheshire, CT

Incorrect insurance verifications can severely affect your bottom line and affect the overall patient experience. You could be driving patients away due to your practice’s inefficiency. Outsourcing your insurance verification service to a third-party dental billing company minimizes rejection claims.

Here at Prospa Billing, we can take care of your insurance verification process. Our billing and verification experts will help you increase your practice’s bottom line by verifying information fully and efficiently. For our insurance verification services, we use only the most advanced software and procedures.

Our experienced medical and dental billing team can take over all of your insurance verification needs – or just a portion of them – to lighten the workload of your front desk staff.

To schedule a consultation, contact Prospa Billing today by calling us at (844) 663-3686 or fill out our online contact form now. We look forward to hearing from you and helping you get back in control of your practice’s finances again.