Insurance Eligibility Verification is the process in which the eligibility of a patient’s insurance benefits and coverage are verified either by call or through the insurance portals so the physicians can provide the medical treatments accordingly and also keep the patients informed about the payment responsibility in advance.
This process can be slightly cumbersome and complex as it involves calling up the insurance company and verifying the respective patient’s insurance coverage benefit details:
- Policy start and expiry date along with coverage and benefit details
- Current status of insurance policy and details on benefits exhausted
- Patient payment responsibilities like Copay, Co-insurance, deductibles, and prior authorization requirements.
MGSI has a dedicated team to handle Insurance Eligibility Verification and follows a standard work protocol to ensure timely verification helping the physician and patients to make informed decisions based on the information gathered during the verification process. MGSI ensures timely verification of insurance eligibility to expedite the patients’ medical appointments and procedural requirements.
How to Verify Insurance Eligibility – MGSI workflow:
- Reach out to the patient’s insurance company either by phone call or via their web portal or fax.
- Verify the patient’s insurance by providing policy information
- Have a checklist of questions to be asked to gain the required information from the insurance company.
- Verify major information like “Effective dates of coverage, insurance coverage limits, treatment services covered, patient payment responsibility details,
- Conditions or treatments requiring prior authorizations
- In-network and out-of-network coverage information to confirm your provider is covered.
- Discuss with patients the verification results and discuss with them payment options based on their out-of-pocket responsibility
MGSI ensures these processes are done in a timely manner to ensure the physicians as well as their patients have the best experience, which in fact helps our clients with complete satisfaction and hassle-free patient service and medical billing support.
To know more about how MGSI the leading medical billing company can help you with your claims processing and insurance verification, call us today.