Prepping for 2017: Key Steps to Verifying Patient Benefits

We’ve recently been filling our blog with ways you and your practice can be best prepared to ring in 2017 (see how to boost your patient collections, CPT code updates, and cost effective ways to market you practice in the new year). Another step to making sure you’re set up for success is to update and/or verify your patient’s benefits and eligibility information prior to the new year. Annual benefits, co-pays, and deductibles for 2016 are running out soon and patients may have insurance plan changes in the coming year.

There are four main categories to focus on when updating benefits and eligibility information;

  • Patient Demographic Information,
  • Insurance Plans,
  • Benefits Verification,
  • And Patient Communications.

Firstly, double check that your patient’s name is spelled correctly and that their date of birth is accurately listed. Verify that the demographic data entered matches the patient’s ID card and be sure to re-verify all information at each appointment.

Are you prepared for 2017? Updating benefits and eligibility information will help set your practice up for success in 2017. Download our checklist today to ensure you avoid costly missteps in the new year.

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Check and confirm the address on the insurance card provided when a patient is scheduling an appointment, and be sure to check the EDI number at the time of benefits verification.

Additionally, confirm that the patient is covered for therapy, when their coverage start date is, plan year, deductible, and out of pocket maximum. Also make sure that when calling to verify any benefits, you obtain the name of the representative you’re talking to and a call reference number – there’s nothing worse than having to repeat the verification process all over again.

Lastly, communicate with the patient prior to their first appointment to discuss their estimated financial responsibility in their therapy program. Ask them if they have an HSA or FSA account and also have them sign a detailed financial acknowledgment form. It’s also important that they understand what benefits they have so they can take full advantage of them. Patient collections can account for nearly 80% of your income in January and February so effective communication with your patients is key.

Download our checklist with this information organized in an easy to follow guide, along with key questions to keep in mind when verifying benefits. Using this checklist and verifying patient information prior to 2017 will ensure smooth sailing into the new year.


Taylor Goldsmith

Content Marketing Program Manager

Taylor Goldsmith is the Content Marketing Program Manager at Clinicient where she manages the blog, social media strategy, supports lead generation activities and more. She provides insightful direction to a variety of other daily Clinicient activities and brings to her team knowledge of core and emerging marketing strategies. Taylor earned a Public Relations degree from the School of Journalism and Communication at the University of Oregon. In her spare time, she likes to travel, explore the Portland food scene, and cheer on the Oregon Ducks.

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