Eligibility Verification & Authorizations
Eligibility verification and prior authorization are crucial steps in the medical billing process. This typically entails confirming patients' insurance coverage and obtaining necessary approvals from insurance companies before performing certain medical procedures. Below Is a detailed version of what this entails:
Insurance Coverage
Oceanic Billing will work alongside scheduling & provide support to verify the patient's insurance coverage to ensure that the services to be provided are covered under their plan. This involves checking the type of plan, coverage limits, active coverage, co-pays, coinsurances and deductibles.
Confirm Patient Information
Confirm that the patient's information, such as name, date of birth, and insurance ID, matches the records with the insurance company.
Document Pior-Auth
Once authorization is obtained, billers document the approval details, including the authorization number and any specific instructions or limitations provided by the insurance company to ensure accurate reimbursement.
Follow-up on Auth
We will follow up with the insurance company to ensure that the authorization is granted in a timely manner.
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