Insurance Eligibility Verification – pVerify - PowerPoint PPT Presentation

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Insurance Eligibility Verification – pVerify


Insurance Eligibility Verification is an important process wherein a provider's practice, healthcare facility checks into a patient's insurance eligibility or coverage. With pVerify you can reduce rejection of medical claims. For any information click – PowerPoint PPT presentation

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Title: Insurance Eligibility Verification – pVerify

  • Tips to Improve Insurance verification in Your
    Medical Practice!

Maintain Batch Eligibility Reports
  • Organizing the details of eligibility
    verification in an easy and coherent manner is of
    utmost importance.
  • Strategize the process where you can deal with
    the eligibility checks for a certain batch of
    patients, all at once.
  • This can be achieved through maintaining batch
    eligibility reports before scheduling a visit for
    the patient.

Know Copay and Deductible Info
  • While you verify insurance coverage to make sure
    whether patient has active insurance or inactive
    insurance, it is also vital that you notice copay
    and deductible information to facilitate
    estimation of patient obligation.

Look at the patients total benefit coverage
  • In order to take a corrective decision after
    verifying the insurance eligibility, check
    patients total benefit coverage. Health Benefit
    Plan Coverage info includes In Plan Network
    Status and Out of Plan Network status. Look at
    this information carefully.

Check Benefit Information Customized to Your
Practice and Procedures
  • Analyze info that is specific to your medical
    practice and procedures such as certain specific
    services covered by the payer.
  • Dive into the service codes that are right for
    your practice.  For example if you are a
    Chiropractic practice, check if the plan covers
    Chiropractic services.

Stop using payer sites and verification hotlines
to check eligibility
  • The next step is to understand that free is
    actually expensive.
  • Spending hours of time on payers sites and IVR
    calls is rather costly for you as it reduces your
    hospitals productivity

  • Through accurate Insurance verification, revenue
    cycle management can be improved by reducing the
    number of rejected medical claims and improving
    the cash flow to the Facility or Providers.

Steps to mitigate the billing complaint
  • To enhance hospitals registration processes to
    reduce errors.
  • To help patient to understand their insurance
    benefits, medical cost prior to scheduling any

Automate Insurance Verification Process
  • Other important step is to automate your
    verification process. Online eligibility
    verification tool offers features such as
    integration with your practice management system,
    access to online portal, rapid access to excel

  • Thank you
  • For more information about insurance
  • Click on
  • https//