The healthcare industry is characterized by complex processes, and one of the most crucial aspects of a successful healthcare practice is efficient revenue cycle management. Verification of benefits (VOB) is a significant part of this process, as it determines patients’ insurance coverage and eliminates potential claim denials. At Compass Revenue Solutions, we offer verification of benefits services to help healthcare providers determine coverage and eligibility for their patients before they even become your client.
Determining Eligibility with Verification of Benefits
Verification of Benefits is a process of confirming a patient’s insurance coverage, benefits, and eligibility for healthcare services. It involves gathering information about the patient’s insurance plan, such as the type of plan, policy number, and coverage details. Insurance coverage can change over time, and if a patient’s benefits are not verified before providing services, it can result in denied claims and loss of revenue.
By verifying insurance coverage and benefits before providing services, providers can ensure that claims are processed correctly and avoid delays or denials. This can help improve cash flow and reduce the risk of financial strain for you. Compass Revenue Solutions works directly with you and the client to determine patient financial responsibility and work with
Our Verification of Benefits Services
Our VOB process typically involves several steps. First, the patient provides their insurance information to your team. This information includes the patient’s insurance card, policy number, and any other relevant details about their coverage. Next, we verify your patient’s coverage, looking through the policyholder information, effective dates, term dates, out-of-network coverage, deductibles, co-insurance, and pre-authorization requirements. Once that is done, our team will update our systems with every detail you need to know to ensure efficient and timely billing. Our wide range of VOB services provide you with every bit of information you need to know to determine if the client is a good fit for your services. These include:
- Coverage + Plan Type
- Pre-Authorization Information
- Lifetime Maximums
- Effective and Term dates
- Co-insurance
- Deductibles + Co-pays
- Payor Restrictions
Our Verification of Benefits Process
- Gather Patient Information: The first step in the VOB process is to gather information about the patient’s insurance coverage. This information may include the patient’s insurance card, policy number, and group number. The provider may also ask the patient about their insurance plan and any specific benefits they are looking to use.
- Verify Insurance Coverage: Once we’ve gathered the necessary information, they will contact the insurance company to verify the patient’s coverage. The provider may need to provide specific codes for the services they plan to offer to determine coverage and benefits.
- Check for Limitations: Even if the insurance company confirms that the patient has coverage for the services they need, there may be limitations or restrictions. For example, the insurance company may require prior authorization for certain services or have limitations on the number of services that are covered. We ensure your team understands the limitations and any additional requirements before providing services.
- Inform the Patient: Once we’ve verified the patient’s coverage and benefits, we’ll let you know about the patient’s out-of-pocket costs so you can begin working with the patient. This may include copayments, deductibles, and any other fees or costs associated with the service. We’ll also let you know if the patient is responsible for any costs that are not covered by their insurance plan.
- Submit Claims: Once you’ve rendered services, we’ll submit a claim to the insurance company for payment. The claim will include all relevant information about the services provided and the associated costs. The insurance company will then review the claim and determine the amount of coverage they will provide.
Benefits of Utilizing Compass Revenue Solutions
- Streamlined VOB Process: Compass Revenue Solutions offers a streamlined VOB process that is designed to save healthcare providers time and reduce administrative burden. Our team of experts is trained to navigate complex insurance systems and obtain accurate information quickly and efficiently.
- Maximized Revenue: By using Compass Revenue Solutions for VOB, you can maximize your revenue by reducing the number of denied claims and avoiding billing errors. The service ensures that all necessary information is collected and verified before services are rendered, reducing the likelihood of denied claims.
- Improved Cash Flow: Compass Revenue Solutions can help healthcare providers improve their cash flow by ensuring that claims are processed quickly and accurately. This reduces the time it takes for providers to receive payment and helps them avoid delayed or denied claims.
- Enhanced Patient Satisfaction: With accurate information about their insurance coverage and benefits, patients can make informed decisions about their healthcare needs and expenses. Compass Revenue Solutions helps provide patients with clear and concise information, which can enhance their satisfaction with the provider’s services.
Schedule A Consultation Today!
Verification of Benefits is an essential process for healthcare providers to ensure that patients receive the appropriate care and avoid unexpected costs. By using a third-party VOB service like Compass Revenue Solutions, providers can streamline the process, maximize revenue, improve cash flow, and enhance patient satisfaction. Schedule a consultation today and call us right now at 678-271-0933.