Eligibility & Verification

There are many medical reimbursement policies, so be proactive in determining insurance verification and coverage, including if prior insurance authorizations are required. For Medicare, if the services are not covered the patient needs to sign an Advanced Beneficiary Notice (ABN). Meanwhile, many leading commercial carriers, such as United Health and the Blue Cross Group, have their own reimbursement policies that can make processing medical bills difficult. That’s why it’s important for medical billing companies to take the time needed to negotiate successfully with commercial carriers should they need to.