Fully 40% of a practice’s problem claims are related to insurance eligibility. We cannot stress enough the importance of making insurance verification a part of every patient’s visit every time.

Problems include: insurance company changes the ID number, patient changes employment and doesn’t know their new insurance, or the patient switches from one Medicare or Medicaid plan to another. Or the patient no longer has insurance and hopes you don’t find out.

Solution: Have a procedure in place for the intake team to verify each patient’s insurance for every visit. Use the insurance eligibility feature of your EMR software, or contact the insurance company directly through their website, or (OMG so low-tech) call the phone number.

Remember that there may be two insurances, especially with Medicare subscribers. It’s important to know which is primary and which is secondary.

Also note that different insurance companies may have similar names. Check the small print on the back of the card to verify the Payer ID and claims address to match to your software’s carrier entry.

Make sure to scan a copy of the insurance cards front and back. This comes in very handy for the billing team should there be any follow-up issues.