Fully 40% of a practice’s problem claims are related to insurance eligibility. Insurance verification will reduce y0ur denials. We cannot stress enough the importance of making insurance verification a part of every patient’s visit every time.

Problems include: insurance company changes the ID number, patient changes employment and doesn’t know their new insurance, or the patient switches from one Medicare or Medicaid plan to another. Or the patient no longer has insurance and hopes you don’t find out.

Solution: Have a procedure in place for the intake team to verify each patient’s insurance for every visit. Use the insurance eligibility feature of your EMR software, or contact the insurance company directly through their website, or (OMG so low-tech) call the phone number.

Remember that there may be two insurances, especially with Medicare subscribers. It’s important to know which is primary and which is secondary.

One annoying thing going against the front desk staff is that some insurance cards have multiple insurance descriptions and logos on them. Try to get them to ignore the big letters on the front and look on the back where it says “Submit Claims To.” Check the small print on the back of the card to verify the Payer ID and claims address to match to your software’s carrier entry.

Make sure to scan a copy of the insurance cards front and back. This comes in very handy for the billing team should there be any follow-up issues.

Let us know if you need an expert billing service to help bring your reimbursements up to what you deserve.

Reimbursement Specialists
info@stlmedicalbilling.com
314-514-5333