Insurance Verification and Authorization Process

Insurance Verification and Authorization processes are crucial elements of the Reimbursement process.  Failure to efficiently perform these tasks may result in Bad Debt and Revenue loss.

Insurance Verification begins with obtaining basic information

  • Demographics:
    • First/Last Name (accurate spelling is essential)
    • Permanent Address information
    • Date of Birth
  • Insurance Name (the patient may have more than one plan)
    • Verify patient name (or subscriber name) matches insurance ID card
    • SSN, Medicare Number and/or Member Number, Group Number
    • Employer as applicable
  • Diagnosis
  • Start of Care date (or estimate if hospitalized)
  • Therapy Type including
    • Drug name(s), strength, dose, frequency and duration