Have you ever had that sinking feeling when a client says, “Will my insurance pay for this?” Or worse, you only find out after the service is provided that their coverage isn’t what you thought it was? This is a common pain point in every industry, but particularly in healthcare. Trying to navigate through a jungle of insurance verification documents, policies, deductibles, co-pays, and eligibility can be a misappropriation of your time, dollars, and your client’s trust!
But imagine, if you could make that entire process, dare we say, fun? Or, at the very least, truly seamless? This is more than avoiding denials, it’s about creating an easy, stress-free experience for your clients right from the first point of contact, and ensuring compensation for your business is easy and timely. Let’s dig in on how to create a seamless insurance verification process.
Why a Seamless Insurance Verification Process is a Game-Changer
A seamless insurance verification process is not only seen as busywork; it is a key factor to both your client experience and your financial health. Here are the benefits that make it a game-changer:
- Happy clients and less stress: No individual wants generic surprise bills in the form of collections or payment plans. A financial obligation confirmed early after onboarding, and obtaining authorization or pre-authorizations is an intrinsically trust-building exercise. When clients are given a clear map of potential coverage at the front of the service experience, that transparency is a leveler that garners trust. Notifying clients of what their insurance information will cover builds trust, lowers anxiety, and builds a positive, hopeful feeling toward their experience within your service.
- Fewer denials & less rework: Oftentimes, the number one issue with claim denials is typically the validity of eligibility verification. If you ensure that the eligibility verification is completed accurately the first time, you will save the lost hours of endless rework and appeals for denied claims.
- Predictable cash flow: Knowing what is covered also allows you to better know what to plan your future reimbursements will be. This allows for better financial forecasting and healthier cash flow for your company.
- Better client and staff experience and efficiency: Staff will have improved workflow when they aren’t bogged down with working through manual eligibility verification or shadowboxing, behind claim denials. Less time on the paper side of a client’s insurance eligibility will allow teams more time to focus on value-added duties and provide clients with better services.
- Compliance audits and inspection readiness: The effectiveness of a written insurance verification process is honesty and accuracy, proving to pagers that you are compliant with their requirements, are ready for audits and inspections, and reduce your compliance risk.
Best Practices for an Easy Insurance Verification
So, how do you turn a potentially messy process into a truly seamless insurance experience? It’s just about using some savvy and the right resources:
- Verify as Early and as Often as Possible: Don’t wait until the end! Verify eligibility as early as possible in the client journey — on initial scheduling or intake, if possible. When providing recurring services, re-verify periodically to catch any changes to coverage.
- Collect Full Information: When you collect client and insurance information, collect all of the information at once: FULL name, date of birth, policy ID, group number, dates of service, contact information for payer (some payers have a different number for eligibility than billing). Check everything twice.
- Use Technology & Automation: Whatever you do, get off the phone tree! Use or invest in a platform or system that can give you all-time verification eligibility. Many practice management programs have built-in components that communicate with payers and return eligibility with a single click.
- Recognize Payer-Specific Differences: Every insurance company has its idiosyncrasies. Some companies require pre-authorization for certain services, while others have their unique referral processes. Your understanding of these distinctions is fundamental to avoiding denials.
- Document Everything: Keep track of every verification clearly and in detail. Write down confirmation numbers, names of agents you spoke with, date/time of call or chat, and coverage details. This will help protect you if any disagreement arises.
- Be Transparent with Clients: Once you have verified their benefits, communicate their benefits, out-of-pocket expenses, and limitations in writing. Transparency fosters trust and eliminates the risk of unexpected billing surprises.
- Dedicated Knowledge: It may be worth considering a dedicated team member or separate external partner, to handle client insurance checks. Some continuity would be helpful and would ensure knowledge and a more rapid turnaround
MCKIOL: Your Partner for a Stress-Free Insurance Verification Process
While these preferred practices may seem simple they can be difficult to do consistently and while doing your core business. The amount of time spent on manual calls, logging into payer portals, and trying to find out where the missing information is coming from is very time-consuming for in-house employees.
MCKIOL is here to help. We are your expert outsourcing partner that will turn the insurance verification process from being a bottleneck to smooth sailing. We are an extension of your business, performing all of the intricacies of eligibility verification efficiently:
- Real-Time Checks: We efficiently check client insurance for speed and accuracy, and we utilize technology that allows us to provide almost instantaneous eligibility and benefit detail checks.
- Denial Prevention: We work to find the things that might be wrong before they become issues, thus protecting against your claim denials and maximizing the revenue cycle.
- Payer-specific Expertise: Our teams understand the niches of different insurance carriers, ensuring information is accurate every time.
- Cost Savings: You gain access to specialist expertise without the cost of hiring or training your in-house team, which will reduce your operating costs.
- Think About What You Could Accomplish: Having part of this time-consuming operational task outsourced frees up time and capacity for your internal team to focus on serving clients or what strategic direction you would like to see the business grow.
Conclusion
At MCKIOL, we recognize that a seamless insurance verification process is key to client satisfaction as well as the overall financial success of your organization; hence, our commitment to outsourcing services to help you operate efficiently and effectively without worry.
Just as our partners, KHP REMOTE FTE help businesses create high-performing remote teams in everything from a myriad of career functions, MCKIOL provides the operational support for service providers to successfully develop processes to optimize their growth in their particular market.
If you want to remove billing headaches and provide your clients with a truly seamless insurance experience, stop letting the verification messiness slow your team down.
Contact MCKIOL now for a chat about how our outsourced expert services can simplify your insurance verification process and impact your bottom line!
Check out our other blogs, i.e., That Insurance Headache? Here’s How to Finally Fix It.
