For the past decade, the #1 denial reason for reimbursement of medical claims has been related to poor insurance eligibility verification. Since then, many have been changed within the healthcare industry, but few things remain the same. As of today, the #1 denial reason still related to the same poor insurance eligibility verification. How is that possible?!

Although technology has significantly improved the receivables of many medical practices, there are many other practices that are still not using technology to its full potential, and consequently spending more money operating.

Re-think your workflow! Time means money! Your staff no longer needs to spend hours on the phone with insurance companies. Technology enables quick coverage verification as:

  • Amount of Deductibles, copayment and cost-sharing;
  • Insurance coverage effective and termination date;
  • Insurance coverage priority (primary/secondary);
  • Type of coverage (medical, hospital, prescription, etc.); and more.
  • It is also possible to request pre-authorization directly from your computer!

The electronic verification of eligibility can be accessed directly from your medical practice management software (confirm availability with your software vendor), and it is also available on most insurance carriers' website, which is a FREE SERVICE. It may require creating an online account with each insurance carrier that you are currently accepting, and keep track of your users ID and password.

It is highly recommended to save a copy of the eligibility verification into the patient's chart (electronic or paper file) and make it available to your billing department, so it can be used later as proof of coverage if the insurance requests recoupment stating patient was not effective on the date of service. This type of recoupment request is a very common practice done by insurance carriers.

Work smart! Start decreasing your costs and increasing your revenue now!