How Insurance Verification Software Helps Businesses

Insurance is required for many business transactions depending on the industry and services needed. However, adequate insurance can be expensive, and the policies are often confusing. As a result, it's common for individuals to provide incorrect information about their coverage.

Unfortunately, this can mean participating in fraudulent activities that result in considerable business costs in the form of denied claims. Sometimes, individuals claim they have insurance for certain services or activities beyond their actual coverage.

More commonly, consumers don't understand all the insurance coverage details. So, how can businesses protect themselves against claims denials that come with false filing? Insurance verification is the only way.

What Does Insurance Verification Mean?

Insurance verification confirms an individual's or business's insurance coverage before an encounter or transaction occurs. The practice's most well-known usage is verifying eligibility for healthcare services by contacting a patient's insurance company to confirm coverage.

However, insurance verification is used in other industries as well. For example, proof of insurance is required to secure a home mortgage loan, when you transfer the title of a vehicle, and to provide certain services as a contractor.

What Is Insurance Verification Software, and Why Does Your Business Need It?

If your business utilizes payments from insurance companies, you need an effective insurance verification system. In today's business world, transactions must happen in real-time to maintain high production.

Yet, if you assume a customer's or patient's insurance details are correct, you take on substantial risks. In the event of a denied claim, you might not get paid. In some situations, you can even be held liable for the results of inadequate insurance coverage simply because you approved the transaction.

Insurance verification software is an application or platform that allows you to verify insurance details in real-time with just a few clicks. The software is typically downloaded by your company or installed by the provider. Often, insurance verification software can be integrated with billing software to provide a seamless process for administrators.

What Methods Could be Used to Verify Insurance Benefits?

Verification involves collecting extensive details from an insurance company about an individual's benefits. The information must include coverage percentages, deductibles, maximums, and limitations.

To access this information, you must contact the insurance company or utilize tools to access information from the insured's policy. This can be achieved in a few different ways:

• Direct communication with the insurance company: This approach generally requires verifying insurance before services. The insured provides specific information about their insurance policy, and a business confirms eligibility through communications with the insurance company.
• Outsourcing insurance verification services: This approach takes insurance verification out of your hands and allows you to depend on a third-party company to verify insurance claims and share proof of coverage. The time required to get a verification may vary depending on your service provider.
• Using insurance verification software: This option allows you to keep insurance verification in-house and provide instant verification of benefits. Insurance verification software can eliminate manual tasks and help businesses save time.

Manual vs Automated

In the past, all insurance verifications were completed manually creating a tedious process that requires the verification specialist to spend hours with insurance companies to gather detailed information.

Any errors in the information provided by the insured, manual data entry, or a misunderstanding with the insurance company can delay the process even further. As a result, it was fairly common to perform services even if insurance was not properly verified.

Automated services provided using modern technology improves the insurance verification process considerably. Eligibility verification software is typically integrated with the billing system of a business and many insurance providers. As such, a business can quickly access relevant information to verify insurance coverage.

What to Look for in Insurance Eligibility Verification Software

Instead of purchasing coverage based on needs, it's common for individuals to buy insurance based on state or employer requirements. While purchasing minimum requirements helps the individual avoid fines and penalties, it can lead to limited knowledge about the coverage provided by a policy.

Intelligent software designed for insurance verification can give a business access to the insured's information. When choosing a system for insurance eligibility verification, it's important to ensure it has these core capabilities.

Integration Capabiliites

Whether insurance verification software is used by a business or insurance company, it's likely the company utilizes various software, platforms, and applications to perform daily tasks. When the systems used within a business don't communicate properly, errors can occur, and more manual tasks are required of staff members. The insurance verification system you choose should be able to integrate with related systems for smooth workflows.

Real-Time Verification

Choosing a system that provides real-time verification as soon as the insured's details are entered into the system is vital. This feature lets your business verify coverage and benefits in minutes to avoid service delays.

Error Scrubbing

Since human error is inevitable, it's important to choose a verification system that can identify missing information or documentation errors and fix any mistakes that have occurred. By ensuring claims are accurate, businesses can reduce denials.