Verification of Benefits 2020-08-11T20:51:32+00:00

Oracle Billing & Solutions, Inc. provides verification for its clients, among many other services. We help take the burden of your regular staff members, who most likely don’t have time to sit on the phone to verify a patients’ insurance benefits, while doing day-to-day operations. Let Oracle Billing & Solutions, Inc relieve the pressure for you. Our staff are fully trained to find the most up-to-date eligibility and benefits data which can increase clean claim rates, eliminate costly rework and accelerate reimbursement.

Oracle Billing & Services, Inc. offers a comprehensive, experienced staff for all of your Insurance Verification needs. We know the questions to ask, in order to get the clearest and most complete answers on what benefits are available to your clients. We have a solid understanding of how insurance WORKS. Do not let incorrect and incomplete benefit information cause your facility denials of services after the fact!

We make sure to get clear, concise and correct benefits for all available levels of care, as well as any maximums on the policy (and what has been accumulated towards those maximums); whether pre-certification is needed for each level, the correct claims address, and much more. Oracle Billing & Solutions, Inc. also have personal relationships with many insurance representatives, which may provide important information about client policies, industry trends, and even how to get paid faster.  CALL Now for a Consultation. 

There are many different insurance companies that provide healthcare coverage, each with several different plan options. Most insurance companies are structured in a way that allows them to offer tiered plan options with the most expensive plan providing the most extensive coverage. Each insurance plan has different costs, as deductibles and premiums vary. Some plans will include in-network and out-of-network coverage, while other plans may only provide in-network coverage. All of the nuances related to the intricacies of insurance plans can become quickly overwhelming. As a result of individuals receiving surprise medical bills it has become common practice for a patient to request coverage verification prior to obtaining any healthcare treatment. It is also a highly recommended practice, even in situations where a patient does not request verification of benefits, for a healthcare practice to require obtaining confirmation of coverage before services are rendered. While obtaining insurance coverage verification may seem like a simple task, it can swiftly turn into a rather daunting and time consuming feat. 

Do Not Waste Time

In situations that are not straightforward, the process to navigate insurance verification benefit complications for staff members of a healthcare practice can be incredibly frustrating. The time your staff could be focusing on other tasks is being wasted as they wait on the phone for unseemly long periods of time simply to obtain health insurance verification benefits for your patients. When a staff member does not know the exact questions to ask regarding the verification of benefits, it can result in inaccurate information being passed on to the patient. It can be especially frustrating when a staff member only receives a partial verification of a patient’s benefits, which would require the staff member to begin the verification process all over again. Although the process may be time consuming, insurance verification is imperative. Furthermore, if it is done so incorrectly, insurance claims may be denied, which can lead to delayed payments. 

Hire A Specialist

Hiring a specialist that is fully trained to find the most up-to-date eligibility and benefits data can increase clean claim rates, eliminate costly rework and accelerate reimbursement. Providing clarity to your patients regarding their health insurance verification benefits is imperative. In order to accomplish extracting from a health insurance company the most clear and complete answers regarding what benefits are available to your clients, a specialist must know the proper questions to ask, and inquire accordingly. 

A billing specialist will make sure to get clear, concise and correct scope of benefits for all available levels of care. This includes gathering a clear understanding of any maximums on a policy as well as the exact amount of money that had previously been accumulated towards reaching those maximums. Inquiring about the need for any pre-certification in regards to a specific treatment, and if so, is it needed for each level, assuring the correct claims address is on file, and more are all taken care of by a billing specialist. Do not let incorrect and incomplete benefit information cause your facility denials of services after the fact.

It is not uncommon for billing specialists, to have personal relationships with many insurance representatives. This can help assure a healthcare facility is in the know should there be any changes. These relationships can also behoove a healthcare practice as important information regarding client policies, industry trends, and/ or even tips on how to speed up the payment cycle arise. 

Further Information

As insurance regulations change, it is imperative that companies understand how each change can affect their practice, in all aspects. Insurance companies are notorious for offering excuses and utilizing loopholes to avoid paying providers what they owe. Accreditations such as CARF and JCAHO are now a common requirement for insurance companies to render payment. These certifications alert the public that a company has been adequately inspected and is considered reputable, meeting the accreditations high standards. The accreditation process can be arduous, requiring a significant amount of time and energy. Our staff offers diverse skills that enable Oracle Billing and Services, Inc. to assist in areas ranging from CARF-Accreditation, Verification of Insurance benefits, Insurance Collection Calls, Drug/Alcohol state licensing, JCAHO-Certification and more. Oracle Billing and Services has extensive experience in assisting companies in the health industry, in understanding the ever-changing regulations as well as providing expert consultation for all areas of operations.