MedManagement Quarterly

Insurance Issues

Insurance Verification....Best Practices

The best practices are using a process to verify the patient’s insurance coverage (i.e., co-payments, deductible and co-insurance).  This insurance coverage may not be known at the time of visit by all patients.  The office staff should obtain this information prior to the patient’s scheduled visit so that this insurance coverage can be confirmed with the patient. 

The goal is to manage the patient’s payment expectations before he/she arrives at the office to receive medical services.  Insurance verification, depending on the payer, can be performed by telephone, fax, online, or through a Web portal.  The office should utilize a verification form, which will assist in the prompt confirmation of the patient’s insurance benefits.  By implementing theses strategies, you will be able to explain and collect the patient’s appropriate payment due at the time service is rendered.