The Front Desk Staff – Benefits Verification

Benefits verification should occur before any service is provided. In fact, the practice should create and enforce a policy that ensures benefits are verified prior to the provision of services. Most payers offer some type of Internet-based 먹튀검증업체 process. Several practice management systems also provide a mechanism for electronic verification. If neither electronic option is available, the practice can contact the insurance company to verify benefits.

If the payer reports that the patient is not eligible for benefits or that the benefits can not be verified, the patient should be informed that full payment must be rendered at the time of service. The practice may establish a process whereby the claim is held for a finite time frame (usually less than one week) to allow the patient to supply updated information. By ensuring the verification process prior to providing the service, the practice can set the expectation that the patient is responsible for payment in advance.

Of course, benefits verification does not guarantee that the patient is eligible. It is possible that the patient has changed employers or benefit levels and that the payer system is out of date. Nor does the verification ensure that the services are medically necessary or approved for payment.

In addition to the eligibility check, the registration process should follow a policy that requires staff to ask for payment on balances along with the necessary coinsurance for the day’s visit. It is best to remind patients (at the time their appointment is made) to bring the balance due with them, and then ask for the balance when they present at the front desk.

In terms of any co-payment and/or coinsurance for the current visit, the practice can seek these funds before or after the physician sees the patient. If the patient is on a percentage basis for the coinsurance (e.g., Medicare), it will be more effective to ask for this payment after the physician has indicated the services provided. This way, the front desk can quickly calculate the expected payment from the patient for the day´s services.

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