Insurance Verification Services in Healthcare | Bikham Healthcare |

Insurance verification services in healthcare are the first and one of the most crucial steps in the medical billing and coding process. It builds up a base for effective management of the revenue cycle.

It has been noticed that most of the claims get denied or delayed for payment by the insurance companies either due to incorrect information or inadequate coverage details provided by the patients during their visit to a doctor.

Denials may also occur when the active coverage information is not updated by the hospital or clinic staff. These rejections may directly impact the cash flow of the company by delaying the reimbursement.

Insurance Verification Services in Healthcare

Outsourcing may help!

Outsourcing these Insurance verification services in healthcare to a company having an experienced team of medical billing and coding specialists may prevent delays and denials in claims. At Bikham, we offer quick and the most efficient eligibility verification services to our clients.

Steps Involved:

Insurance verification services in healthcare includes four important steps viz.

  • Documentation

Documents are analyzed thoroughly upon the receipt from doctors or healthcare providers. These are then verified against a checklist of necessary documents. It helps to organize the documents as required by the insurance companies

  • Coverage Verification

Insurance coverage of the patient is verified with their stated primary and secondary payers, either by contacting them directly or by checking their official online portals.

  • Follow-up with Patients

Patients are contacted to obtain missing or incorrect information. This helps in keeping the correct information updated. The cross verification of patient details before the final submission is also made.

  • Final Submission

The final results are provided to clients including the eligibility and benefits information along with details such as correct group ID, member ID, effective and termination dates of the insurance and patient responsibilities etc.


Benefits associated with successful eligibility verification:

Patient eligibility verification is of utmost importance as it directly affects the cash flow. It offers a wide array of benefits to physicians such as:

  • Improved Cash Flow

The access to updated eligibility data favors the chance of getting a claim quickly accepted and processed. This way, a constant cash flow with a significant reduction in denials is experienced. Write-offs are reduced and patient satisfaction increases automatically.

  • Streamlined Workflow

The overall efficiency of the processes improved with consistent and concise eligibility responses. This consistent and streamlined approach leads to an excellent patient experience and fewer denials.

  • The boost in Self-pay Revenue

The electronic matching of the patients with the insurance databases provides physicians a better chance to obtain additional reimbursement. This helps in the identification of patients unaware of their coverage, reclassifying them and submitting their claims, to free them of any financial burden.

Therefore, a systematic approach to streamline insurance eligibility verification process must be adhered, to ensure increased claim acceptances and reduced claim denials. Bikham Healthcare offers quick and the most efficient eligibility verification services to their clients. Being 100% HIPPA compliant, they ensure complete privacy of the confidential health information. And, the 13 years of extensive on-hand industry experience compliments the dignity.


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