67% of Americans are worried about unexpected medical bills. Insurance eligibility verification is never pleasant. There are too many checks and requirements to comply with. A patient has to verify their identity and provide detailed medical information to prove that they are entitled to reimbursement.
Slightly over a decade ago, the verification process was mostly manual. Patients and clinicians had to file multiple forms and hand them over to insurance providers. Fortunately for everyone, today, we have automated insurance verification systems.
Now healthcare providers can use convenient health insurance verification software to verify eligibility before each appointment. Insurance verification systems automatically run checks to show what insurance benefits cover — and what they don’t.
Address verification takes a considerable place in the eligibility and benefits verification process. It allows healthcare organizations to validate patients’ identity, prevent insurance fraud, and optimize billing.
More about insurance verification systems and address verification solutions in our blog article on:
- What is insurance eligibility verification?
- Health insurance verification software: when and why to use
- Importance of address verification in insurance verification systems
- How to verify an address automatically with Inkit?
What Is Insurance Eligibility Verification?
Eligibility and benefits verification is a series of steps that enable healthcare organizations to check whether an admitted patient can receive reimbursement from an insurer. An organization either contacts the insurance company directly or uses specialized health insurance verification software to automate the procedure.
Generally, patient insurance eligibility checks take the following steps:
- Patient scheduling and enrollment. A patient schedules an appointment with a doctor. The healthcare provider records the patient’s personal information and medical history to send the insurance company accurate data.
- Eligibility and verification. The healthcare provider runs the patient’s data and address verification to prevent fraud and make sure they are eligible to make a claim. At this point, the insurance verification systems are used.
- Claim authorization. The insurance company is bound to authorize the claim and pay the specified amount. At this stage, preliminary insurance eligibility verification is essential to prevent denial.
- Eligibility information updates. The healthcare provider notifies the patient about any changes to the claim. Now, the verified personal and contact information is critical to reaching the patient within the shortest time.
- Claim transmission. The claim request is sent to the insurance provider that reimburses the expenses based on the previously agreed conditions. This is the final stage of the eligibility verification process.
When a healthcare organization integrates insurance verification systems, most of the above processes happen automatically. This helps to speed up claim processing, optimize healthcare services, increase revenue, and more.
Health Insurance Verification Software: When and Why to Use
Healthcare organizations are the primary users of insurance verification systems. They need health insurance verification software each time a patient with insurance coverage is admitted. The use of health insurance verification software helps them inform the person about reimbursement options and share reliable information on future healthcare expenses. They can batch check insurance eligibility before appointments or verify each patient separately.
Today, all large healthcare providers have health insurance verification software in place. This allows them to serve a large number of patients and minimize insurance claim denials. As a result, more people receive quality services, and the cooperation with insurance companies is much smoother.
Here are some other valid reasons to adopt health insurance verification software:
Improved cash flow
With insurance verification systems, healthcare providers don’t have to bother about billing or how to verify an address. The software does all the routine tasks. They automatically get reliable data to generate clean claims and have patients’ bills paid shortly after. This reduces the risk of late payments and bad debt.
When health insurance verification software automates insurance eligibility checks, a healthcare organization can treat patients sooner. It can save time usually spent filling in patients’ data, filing claims, and waiting for a response. Whereas people receive better treatment, healthcare providers and insurers optimize their work by delegating a large share of everyday tasks to the software.
Focus on patient treatment
The health of a patient should be the ultimate goal of healthcare and insurance companies. Unfortunately, when it comes to reimbursement of expenses, they don’t always find common ground. The use of insurance verification systems regulates the relationships between healthcare organizations and insurers. Thanks to this, doctors can focus on treatment instead of insurance coverage issues. Automated insurance checks also enhance the quality of services and patient satisfaction rate. According to estimation, 92% of people want to know the cost of services before a provider visit. Insurance software with identity verification allows them to stay informed.
Importance of Address Verification in Insurance Verification Systems
Eligibility and benefits verification is a complicated procedure consisting of multiple checks. In our article, we want to talk about street address validation as one of its components.
Health insurance verification software is usually integrated with an address management system or includes address validation features. Such a combination allows healthcare providers to verify address lists and patients’ identities automatically. As soon as a person registers for an appointment, the software checks their personal and contact information. Once the identity is established, the data is automatically transferred to an insurance company to clarify the insurance benefits.
Overall, address verification is necessary for the insurance verification system for the following reasons:
- To check whether the provided personal information is valid and the patients are who they claim to be (Learn more about address verification for validating patient data)
- To prevent insurance fraud and make sure only eligible patients receive reimbursement
- To deliver crucial insurance documents to the right patients or caregivers
Address validation is essential at every stage of the patient’s journey in a healthcare organization – from the moment when a person makes an appointment to the claim transmission. Without automated address validation, you won’t be able to implement a full-fledged automated insurance verification.
How to Verify an Address Automatically with Inkit
Inkit is a cloud-based reach enablement platform with data validation and hundreds of integrations supported. It can substitute an address management system and perform automated address verification for insurance eligibility checks.
Inkit Verify, one of the tools available in Inkit’s platform, is the service healthcare organizations should use to validate addresses. It provides address autocomplete to help patients share the contact information when they arrange an appointment. After the data is recorded, Inkit checks it for mistakes and validity.
To run the verification process, Inkit cooperates with the United States Postal Service. The USPS has given it access to official databases with updated street addresses, ZIP codes, city and state data. The tool automatically matches address records with USPS addresses to standardize them, add missing details, or detect invalid addresses in real-time.
In addition to address verification capabilities, Inkit also enables healthcare providers to send online and offline communications. It can automatically deliver updates to patients and insurance companies based on triggers. For example, when an insurance company denies a claim, the related patient will be instantly informed about this.
Would you like to have address validation in your insurance verification systems? Contact our team to integrate Inkit.