During times of uncertainty, many practices may be struggling financially. Challenging times make it essential to ensure that you are appropriately reimbursed for all services rendered. Verification of benefits is necessary to understand the patient's medical benefits and what procedures are covered under the plan they have chosen. Accurate verification of benefits is vital to the financial success of your practice.
Now is an opportune time to examine the verification process with your staff and confirm that the appropriate employees have a solid understanding so that you can start 2021 off on the right foot.
Unfortunately, it is not uncommon to come across practices without policies in place for verification of benefits. It is impossible to know what services will be covered without verifying. Is this your practice? Are you treating patients and providing your time and expertise and not being reimbursed because benefits were not obtained or are not clear?
The Importance of Eyecare Insurance Verification in 2021
- Is your patient the subscriber or a dependent?
- If they are a dependent do you have all information necessary on the subscriber (Primary member).
- Are dependents covered?
- Has the patient provided the most current card from the Payer?
- Do you have the correct card for Medical? Vision?
- Confirm the card is not for Dental or Prescriptions.
- Do you have the correct ID and Group number for the plan?
- An insurance card does not mean the subscriber ID is accurate.
- Due to privacy, Carriers have changed patient IDs and issued new cards. If you are not verifying, you do not know if you have the most current information.
- What is the Payer ID?
- Rejections can occur if the claim is not submitted appropriately.
- What is the effective date of the plan?
- Just because the patient provides the information to you does not mean their coverage is active.
- How much is the annual deductible?
- Do your staff understand the term?
- Is there a Family deductible? An Individual deductible?
- How much of the deductible has been met?
- Is there an out-of-pocket expense?
Making the maximum amount of revenue on your insurance reimbursements is easier with our free guide.