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Eligibility and verification

January 28, 2020

id-verification-blockchain

When the patient arrives the day of the appointment, the first thing your staff should be verifying is the patient’s insurance. Sometimes you find that insurance has changed in just the short period between scheduling and appointment day. Another reason for insurance verification is to prevent or detect insurance fraud/identity theft. According to The Institute of Medicine over $75 billion annually is lost from the U.S. Healthcare System due to insurance fraud. Having your staff check for duplicate records and payment fraud is important. Ensuring your staff is checking the eligibility of insurance before service can aid in the detection of insurance fraud. How does your practice prevent such fraud? Simple, your practices part in it all is to ensure the insurance is in fact tied to the patient. To do that, it is vital that your staff verifies the identity of the patient first and then searches for any records attached to that patient.

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