Eligibility verification is your first line of defense against claim denials and patient payment issues. A thorough verification process prevents 90% of coverage-related problems, but most practices only check basic active coverage and miss critical details.
Your checklist should include: active coverage dates, copay/deductible amounts, prior authorization requirements, referral needs, covered services for your specialty, out-of-network penalties, and coordination of benefits with other insurance. Don't forget to verify coverage for specific procedure codes, not just general medical services.
Time-saving tip: Verify eligibility 24-48 hours before appointments, not at check-in. This gives you time to resolve issues, obtain authorizations, or reschedule if necessary. Real-time verification at check-in creates bottlenecks and patient frustration when problems arise.