Step 2 - Verify Insurance Eligibility

Checking a patient’s insurance eligibility and benefits is essential to your practice income and productivity. Your staff can perform eligibility checks in several ways depending on the processes you follow in your practice. To verify information, you can follow one of these methods:

Method 1 - Check the website of the insurance carrier to verify if the information on the patient’s insurance card is up-to-date and correct.

Method 2 - If you have hired managed billing services, the company can check patient insurance eligibility on your behalf. This will save you time and effort.

Method 3 - Call the insurance representative directly. When you have the payer rep on the line, make sure to ask these questions and gather crucial information:

Questions to Ask for Insurance Eligibility Verification

Q: Can you confirm the patient’s policy and group number? Q: Can you confirm the name of the insurance holder Q: What is the relation of the insured to the patient? Q: Can you confirm if the patient’s insurance plan is active, and if so, what is its end date? Q: How many visits does the patient have left this year? Q: Can you confirm your claims address? Q: What is the patient’s copay and/or coinsurance? Q: What is the patient’s deductible? Q: Do you require pre-authorizations or physician referrals? Q: Are there any coverage limitations? Q: Is our provider in- or out-of-network?