Importance of Insurance Verification Services in Healthcare Industry

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Importance of Insurance
Verification Services in
Healthcare Industry
It is imperative that medical
care providers understand
the importance of insurance
verification services in the
healthcare industry. It plays
a major role in a hospital's
claims denial management
program. Successful billing
depends on successful
eligibility verification. Health
insurance verification is all about the process of checking
a patient’s active coverage with the insurance company and
verifying the eligibility of his or her insurance claims.
In order to avoid claim rejection, the verification process
must be done before the patient is admitted into a hospital.
Otherwise, it might lead to denials and need for rework.
Patients would be ineligible for benefits when they provide
wrong or outdated information, or when their policies have
been terminated or modified. A simple error can result in
claim rejection or denial, so you have to be sure it is being
done correctly.
Maximize Reimbursement and
Minimize Denials

A health insurance verification specialist, also called
insurance verifier, plays a big role in the health insurance
system. These professionals work with patients, complete
paperwork, and verify patient information with the insurance
carrier to maximize reimbursement and facilitate revenue
cycle improvement.
The service includes verification of:
• Payable benefits
• Co-pays
• Co-insurances
• Deductibles
• Patient policy status
• Effective date
• Type of plan and coverage details
• Plan exclusions
• Claims mailing address
• Referrals & pre-authorizations
• Life time maximum, and more
Insurance Verification Process
Insurance eligibility verification involves many steps.
• Receiving patient schedules from the hospital via EDI,
email or fax
• Verifying patients’ insurance coverage
• Contacting patients for additional information
• Updating the billing system with eligibility and
verification details such as coverage start and end
dates, member ID, group ID, co-pay information and
much more.
Seek Professional Help from a
Reliable Service Provider
To take the stress out of managing these tasks, it is better
to outsource insurance verification services to an
outsourcing company that can get your claims billed and
processed accurately. Because of the importance of
insurance verification services, it is imperative to select
only experts in the field. A reliable company will help in all
ways to meet your insurance verification demands. By
outsourcing your requirements, you can gain many benefits

Reduced effort and time

Speed up approval and authorization

Simplified workflow

Faster billing cycles

Improved staff productivity

Reduced operational costs
Every healthcare practice should give primary importance to
insurance verification services because this can greatly
impact its bottom line. Rejections and improper payment
result in rework and resubmission of the claim. So it is
important that you select the right provider delivering
quality and cost-effective patient eligibility verification
For More Information:
OutSource Strategies International
United States Main Office
8596 E. 101st Street, Suite H
Tulsa, OK 74133
Phone 800-670-2809

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