How Eligibility and Benefits Verification Create A Better Patient Experience

How Eligibility and Benefits Verification Create A Better Patient Experience


By Christine Schneider, VP of Operations

That’s what many patient care coordinators may think when faced with the decision of whether to verify eligibility and benefits by phone prior to a patient’s visit. But what if that extra step actually creates a better patient experience? What if the call makes the patient happier in the long run?

Eligibility and benefits verification is advantageous to patients. Practices can collect the proper amount due at the time of service so there are no billing surprises down the road. When the bill arrives, everything matches the patient’s expectations. That only enhances the patient experience.

Verification also provides the practice with information about a patient’s benefits that, well, will benefit the client. For instance, a practice might find vision riders inside of a medical benefit or a vision plan that a patient may not have been aware of.

That all helps increase patient’s overall level of confidence and create a better patient experience. Not to mention, your practice will be able to stay on top of accounts receivables.

If Your Practice Still Has Reservations About E&B Verification, Here Are A Few Thoughts For Implementing A Process:

1. Help your patients understand the value of E&B verification.

Some patients might push back when you call in advance for their insurance and personal identification information. That’s okay. Take a deep breath and simply say, “Hey, Mrs. Smith, I would like to verify all of your insurance information at this time, so we’re completely prepared when you arrive for your appointment. We don’t want to create any delays on the day of your appointment trying to track down missing information or finding out at the last minute there’s an eligibility issue.”

Your patients will adapt to your processes if they understand the reasoning behind them.

2. Keep your list of insurance providers orderly.

E&B verification is the opportunity to properly list your patient’s insurance provider in your system ahead of time. Insurance provider lists get very messy, very fast. There can be lists with 20 different versions of Aetna or 20 different versions of Blue Cross Blue Shield. In the old days of snail mail, there might have been a matching number of mailing addresses.

But with electronic submission, it’s much more common that every Aetna submission or every Blue Cross one uses one payer ID, which means only one insurance company is needed.

When you check this ahead of time—and keep an orderly, and up-to-date master list—you will be able to bill efficiently. And your patient will receive their statements more quickly, which will create a better patient experience for them.

3. Don’t forget to scan the card and collect the co-pay.

When the patient arrives for his or her visit, your team member should still scan the insurance card. Practices will need that on file for easy reference should there be questions later on. No one wants to have to call the patient after the exam, because of missing information on the policy.

With E&B, the appropriate copays are all going to be collected upfront. It leads to less patient billing after the exam and easier payment posting when the insurance payment comes in, because everything matches what was expected.


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