Why Benefit Verifications are essential to the success of your practice

November 20, 2024

   Okay, let's talk benefit verifications!  In my 21 plus years of Medical Billing, one of the most important things I learned is Benefit Verification's pave the doorway   for a successful practice!  But why is it so important?



  • Just because a client's insurance is an insurance that you are in network with, does not mean that you take their specific plan. Verifying benefits prior to a patient being seen at your practice is a proactive approach to ensure a positive experience for both you and your patient. Of course, there are some cases where that is not possible such as emergency situations, however, when possible, I encourage you to ensure that is included in your medical billing services if you outsource. 
  • Being transparent with your patients by providing them with a quote of benefits ensures a positive patient experience.  There is nothing worse than finally finding a provider that you are happy with, only to be slammed with a $500.00 bill.  Not only are they upset about how they are going to pay for this bill, they are also upset that they now cannot afford future services.  This leads to poor patient retention, negative google/yelp reviews, and angry calls to your practice.
  • This approach helps ensure successful cash flow.  It is super frustrating to bill an insurance plan only to find out 30 days later that their plan is carved out to another insurance for the type of service that you provide.  Then you or your billing company are spending countless hours trying to obtain the information for the carve out plan.
  • Even if the billing company that you partner with verified the patient's insurance in the past, it is always important to re-verify benefits, especially at the beginning of each new year.  A lot of employer's change the plan that they partner with, and the client may have a new identification number or different plan altogether.  Then you are again spending countless hours trying to obtain the updated information from the client, then only to find out that you may not take the new plan leading to the client being stuck with a hefty bill that you may or may not ever be paid on!



   Can the above cause patients to cancel their service before they even step foot in your door?  Of course, however, being transparent with them and quoting them with their potential out of pocket expense prior to being seen, will avoid negative reviews on social media sites/google, as well as providing a service with the possibility of never being paid. What if benefits are quoted incorrectly?  Yes, this does happen, I always encourage providers to make it known to their patients that this is only a quote of benefits, and the actual amount will be determined when the claims have been finalized by their insurance.   I could go on and on with reasons why this is so important, however, I will leave you with this final note.  Being proactive, rather than reactive as well as transparent to your patients is always going to ensure your success!

Why it is so important to choose a quality billing company.

November 23, 2024
Okay, lets talk about choosing a billing company to partner with and why it is so important to choose wisely! When weighing the options on which billing company to choose, it can be a very daunting task. If one company charges a lower fee for the same services, it would be a no brainer to choose the one that is more cost efficient, right? In my 21 plus years in billing, I found that this is not always the case. I am not insinuating that more expensive means higher quality as with any service, however, it is best to always weigh out your options and do research on any company you are considering. It is incredibly important to choose a company that is going to provide the best customer service to both you and your patients. The revenue that comes in is the backbone to the survival of any practice, and choosing a quality billing company is super important in both patient retention as well as revenue. When choosing a company, I encourage you to look at some of the following: What services are included with the fee? When interacting with your patients, will the billing company explain their bill to them in detail with kindness and compassion? Will they provide a quote to your patients (when possible) of their benefits and a quote of what their out-of-pocket expense may be prior to the service being provided? Will they respond to patient inquiries timely? Will they respond to your inquiries timely? How involved is the owner of the billing company in everyday practices? Will they provide the same effort if you are a small practice as they would with a large practice that has higher revenue? How long is the billing contract for? You may want to weigh out your options when signing a long-term contract as that can make it difficult if you are unhappy with services. Will they follow up with insurance companies in a timely manner on denied or unpaid/underpaid claims? Are they willing to tailor to your specific needs? When providing billing services, what works for one practice may not work for another, so it is always best to choose one that will be flexible and willing work with your processes to ensure a smooth transition for both you and your patients. Is the billing company employing knowledgeable individuals? This will ensure claims are billed accurately and appropriately! Do they charge the fee whether your practice is paid for that service? I know this sounds like such a stressful search, however, in the long run it is sure to ensure your success!
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