A Guide to Insurance Verification in 2024

It’s hard to believe we are coming to the end of another year. For those of us in the revenue cycle profession, the new year means one thing: new insurance plans. Most employers and Medicare patients begin with a new plan on January 1st, and oftentimes, Medicare patients will have been switched to a new MCO plan without them even realizing. Now is the time to start educating your staff on the importance of asking all patients for a copy of their insurance cards, so you don’t get stuck with revenue cycle issues in 2024. 

Having a copy of the correct insurance is important for several reasons: 

1. The first, and most significant, is that it directly affects the revenue cycle for your office or facility. When a new card is not taken and verified, it delays your payments and causes an increase in denials.
   
   
2. Second, if there are any errors when the information is entered into the PM system by the front desk staff, your billing staff will have the card to reference and make any changes that are necessary without having to call the patient. It is always easier to get the information from the patient when they are in the office for their visit, versus a follow-up communication. Patients are often leery of scams and are not always willing to provide information over the phone. 
   
   
3. Third, a copy of the insurance card is helpful to the billing staff if there is ever a need for an appeal with the insurance company. 

Once you’ve established the importance of collecting up-to-date insurance information from patients (the why), it’s critical to also educate your team on the correct way to collect it (the how). We all know that the front desk staff are very busy checking in patients, answering the phones and scheduling appointments, which can result in issues collecting the insurance details. Asking a patient “if anything has changed” is not a good way to update their information. The staff should instead ask the patient to verify their address and a current phone number, in addition to asking for their insurance card. This is a good practice to follow for every visit, not just at the beginning of the year.

When the patient does present their card, it is important to scan both the front and back of the card into the Electronic Medical Record (EMR)/ Practice Management (PM) system. Eligibility should then be verified. Most EMR and PM systems are able to verify eligibility electronically, which also helps to avoid delays in claims payment.

Educating your front desk staff on the significance of insurance verification and the appropriate steps to collect it will result in less claim denials, increased cash flow and an improved Accounts Receivable in the new year.