Insurance Elegibility Verification

Insurance eligibility verification is the method by which healthcare providers ascertain whether a patient has insurance coverage and benefits for medical services.

They ensure that the patient’s insurance is active and that the services they require are covered by the insurance plan. To accomplish this, providers gather and verify the patient’s insurance information, such as policy number, group number, and subscriber name.

Providers can either do this themselves by contacting the insurance company, or they can use electronic systems to verify insurance eligibility. Checking eligibility is critical to ensure that patients receive the medical services they require without payment difficulties.

It also aids providers in giving accurate estimates to patients of their out-of-pocket expenses before billing. In summary, insurance eligibility verification is critical in the healthcare industry for patient satisfaction, regulatory compliance, and accurate billing.