This may seem crazy, but when it comes to handling your insurance claims, you have no idea what’s happening.
We’re not blaming you – we know from experience that customers like yourself have little-to-no education when it comes to handling claims. It’s not like insurance providers give out formalized training to customers on how they can maximize their benefits. Without that, there are very few – if any – places where you could have your queries answered.
Our story is a bit different – we can handle the process, because we learnt by doing. At first, we paid a professional billing company to do our verifications, and found out the hard way that they did not know the process as well! Thinking it a double loss to pay for shoddy work, we decided to take on the task ourselves.
We worked on it and were wrong several times, but we managed to learn from our mistakes and eventually, figured the process out for ourselves. And here is what we learnt.
- Verifications are like a home’s foundation – if not done right, it will cause incessant problems down the line. Speaking in terms of billing, faulty verification will affect claims process, lead to re-filing, extra payments as well as write offs.
- When not done right, it can offset the claims process or even derail it entirely. Especially relevant in 2023-24, notifying a Third-Party Administrator of a patient with an available yet-to-be-used ‘discount’ is a major factor. The reason why the discount is worded this way is because while this is treated as a benefit for patients, it is technically less than the amount of services offered at a lowered fee. Thus, it technically provides no real benefit. In terms of healthcare, this is not acceptable.
We understand the importance of verifications – so much so that we offer them free-of-charge to customers who opt for our submission & claims services. We understand how they have to be done the right way to make sure that coding and submission, and of course billing are all done properly. This will also liberate your office’s staff from having to deal with the insurance hierarchy – and spend more time on actual healthcare.
