Eligibility & Benefits Verification

Eligibility & Benefits Verification

One of the many tasks that your front desk staff does is verify a patient’s eligibility and insurance benefits. We understand how hard it must be for your staff to juggle calling every patient’s insurance company and answering phone calls about scheduling appointments at the same time. Phew! I’m tired just thinking about it. Verifying a patient’s insurance plan must be done before the patient gets admitted to any hospital, clinic or medical facility in order to avoid claim rejection. Filing for claims rejection is such a hassle and very time-consuming. Make sure that the written patient information written is correct and up-to-date. Also make sure that the policies are active and weren’t modified. Even the tiniest and simplest error can result to a claim rejection or denial. Be sure that you’re very thorough and keen.

Minimizes Denials and Maximizes Reimbursement

A person who ensures a smooth-sailing eligibility and benefits verification is called an insurance verifier. They are one of the most important parts of the staff. They work with patients, handle all the paperwork, and verify patient information with their own insurance carriers so that they can facilitate revenue cycle improvement and maximize reimbursement.

Insurance verifiers make sure that these items are verified:
Payable benefits 1.Co-pays 2.Co-insurances 3.Deductibles 4.Patient policy status 5.Effective date 6.Type of plan and coverage details 7.Plan exclusions


8.Claims mailing address 9.Referrals & pre-authorizations 9.Life-time maximum, and more. The Insurance Verification Process. Steps for insurance eligibility verification. Receive patient schedules from the hospital, clinic or medical practice. Verify a patient’s insurance coverage. Contact patients for additional information. Update the billing system with all the eligibility and verification details such as the start and end dates of a patient’s insurance plan, their member ID, group ID, co-pay information and much more.


Outsource from a Reliable Service Provider

To help lessen your front desk staff’s workload, why not outsource your insurance verification services? There are a lot of outsourcing companies, like DrCatalyst, that can help carry your insurance verification burden. An outsourcing company can help get your claims billed and processed accurately. However, you should make sure that you only hire experts so that your claims won’t get rejected or denied most of the time.

These are a few things that you can benefit from outsourcing your insurance verification services:

1.Reduced effort and time 2.Speed up approval and authorization 3.Simplified workflow 4.Faster billing cycles 5. Improved staff productivity 6.Reduced operational costs

Patient Details

For new patients, insurance verifiers should confirm the following insurance information:

Patient’s name and date of birth
Name of the primary insured
Social security number of primary insured
Insurance carrier
ID number
Group number

Contact information for the insurance company including phone number, website and address for submitting claims