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Joy Hicks

Insurance Verification: The 5 Most Important Questions to Ask

By March 8, 2012

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The revenue cycle should begin prior to the patient's arrival. As soon as the appointment is made, the patient's insurance information needs to be verified. Because insurance information can change at anytime, even for regular patients, it is important that the provider verify the member's eligibility each and every time services are provided. There are many benefits to obtaining insurance verification prior to the patient's arrival.

When verifying a patient's insurance, remember to ask these 5 most important questions:

  1. What is the effective date of the patient's policy?
  2. Is the coverage currently active?
  3. Is the diagnosis, procedure, treatment, or visit covered?
  4. Are there any limitations or policy exclusions?
  5. Does the procedure require prior authorization or predetermination?

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