Health Insurance Verification Tools
Both patients and their health care providers should verify health insurance coverage before seeking or providing services. Confirming health insurance eligibility prior to rendering services will save administrative and financial hassles later should the patient not have coverage at the time of the service. Health insurance verification tools are essential to confirming eligibility and take shape in the form of several different methods. The upfront research with these tools to verify health insurance coverage is worth the effort for all.
Telephonic Customer Service
Most, if not all, health insurance companies offer a customer service phone number to verify health insurance information. They often have separate phone number or routing options for their members and health care providers. Any member or provider can call the insurance plan to verify health insurance eligibility. He must have the patient's name, social security or member identification number and date of birth at the time of the call. With this information in hand, the insurance company representative can confirm patient eligibility at the time of the call. Some insurers have automated this process so eligibility can be confirmed through an interactive voice response system rather than speaking with a representative.
Identification Cards
Members of a health plan, whether it is a commercial health plan or government-based health plan such as Medicare or Medicaid, will receive an identification card. The card serves the purpose of verifying a member's participation in a health plan. The member ID card will contain the member's name, member ID number and health plan name, at a minimum. Depending on the type of plan, it may also contain the name of the patient's primary care physician. Providers should ask for the card before rendering services and make a copy of the front and back of the card to add to the patient's record for reference.
Online Verification Tools
Health insurers often maintain websites for the members and providers. These sites require registration to obtain a log-in. Within the website, the member can access information about her health insurance plan and often can confirm the benefits available to her . Providers who have contracted to participate in the health plans network can look up patients on the website to confirm their patient's eligibility and coverage. Usually updated daily and sometimes in real-time, these tools provide the most current information available. Medicare's website allows people to see if they are eligible for Medicare services (see Resources), and several states offer providers an option of eligibility verification online for Medicaid programs.
Tags: health plan, verify health, verify health insurance, health insurance, Verification Tools
