Krogsgaard Frandsen posted an update 2 months, 1 week ago
One thing that no medical professional likes to deal with is insurance. Insurance is a nuisance, it’s not always simple to comply with, and they have several different requirements. What’s worse is that it can seem quite difficult to those who don’t go through the process day after day.
We’re here to tell you what is health insurance verification and how the process works.
What Is The Health Insurance Verification Process?
The health insurance verification process is a series of steps that check whether the patient can make a reimbursable claim to their Mental Health Insurance provider. The process is complex and goes through many different people at both the healthcare provider and the insurance provider.
Mental Health Insurance Verification process in Austin includes deductibles, plan exclusions, policy status, and other things that affect cost and coverage. This always occurs before any treatment to understand how the patient will be paying.
The Critical Factors of Claim Denial
The prime factors of claim Rejection are incomplete insurance verification, missing patient data, claim billing errors, coverage effectiveness, termination dates, expired policies, and duplicate data. These always result in non-payments, claim denials, claim rework, delayed payments, and additional costs to the provider and the patient. Resulting in patient dissatisfaction, decreased revenue, and in these days of YELP and Google reviews can even tarnish the reputation of the provider.
Complete Cycle of Insurance Eligibility Verification Process:
It all begins with Mental Health Medicare specialists providing patient information to their outsourcing partner. There, experts examine the patient’s data and use it to start insurance eligibility verification.
Insurance Eligibility Verification
The most significant reason for claim rejection is missing or incomplete data. An outsourcing partner should always ensure they have the most up-to-date and complete information. This occurs by reaching out to the patient’s insurance agent. Some of the reasons a patient’s coverage may have changed are marriage, divorce, or childbirth.
Outsourcing insurance professionals will connect with primary and secondary payers to get a comprehensive view of the patient’s coverage. They will cross-check insurance coverage details to guarantee the maximum claim will be met.
Patient Follow up
Timely appointments and therapies are a must for Mental Health Benefits Claims’ eligibility.
By using automation tools, patient follow-up is easy. Using automation services and solutions, patients can receive emails, notifications, phone calls, or texts regarding upcoming appointments and treatments. In the case of appointment cancellation, patients will get an instant notification and rescheduling choices. All of this helps to improve the patient experience and create satisfaction with their healthcare provider.
Updating the Billing System
A provider’s outsourcing companion will ensure the insurance verification process has been recorded correctly in the provider’s billing system. A partner well-versed in the whole revenue and treatment cycle can ensure that all patient data are recorded accurately from the first appointment to final discharge.
With a smooth insurance verification process, a provider ensures regular cash flow and sees higher degrees of employee and patient satisfaction. It’s often beneficial for providers to seek advice from outsourcing partners who specialize in the Mental Health Verification process.