Wiki Insurance Verification-How do I make sure info is accurate?-When I verify

[KrisK]

When I verify a new patients insurance over the phone I am getting some incorrect information (discovered when the bill does not get paid)...looking for suggestions on the most accurate way to determine patient responsibility prior to 1st appointment.

 

[mitchellde]

If you are verifying coverage with the payer that is the best you can do. However most commercial payers have a 90 day float for coverage so if the premiums have not been paid the patient is still considered covered for 90 days. If no premiums are paid by then end of 90 days then the coverage is suspended all the way back to day 1 of the 90 days, and any claims paid will be requested for refund and any claims not yet paid will be denied.
The bad thing is there is no way to know if the premiums are up to date. You only are told that the patient is covered the day you check.