The Right Questions to Ask to Find the Right Insurance Verification Company

Welcome back to our medical practice optimization podcast, the show where we take a deep dive into the world of healthcare and explore how innovative practices can improve patient care and streamline operations, and how we can help you as well.

I’m your host Rajeev Rajagopal, and in today’s episode we’ll discuss the topic that I covered a little bit about last time, which is about outsourcing of insurance verifications and eligibility verifications and how that could help you.

Well, let’s get started.

Why did you do it? Why would you like to do it? Well, that’s something that I covered last time when I spoke. It’s basically expertise and efficiency, cost savings, times, flexibility, scalability. I mean, you’re a company that could be growing, you’re a practice that could have more patients next year. Would this company grow with you? That’s important. And then of course, enhancing your patient experience and obviously all this will improve your continuous process improvement, that’s, in your facility.

Now you are looking for a company. You realize this is something that could help you. How do you find out if the company’s right? Well, let’s cover that today.

Today, it’s all about how to find the right company.

01:16 Five Important Questions to Ask to Choose the Right Insurance Verification Company

And, let’s see if these questions help you identify the right company for yourself.

When looking for a new company, it is essential to ask the right questions to ensure that they meet the practice’s needs because every practice is different. You know your practice is different as well.

1. First question I normally would like to ask is – what is your experience in the healthcare industry and patient eligibility verifications? Seems simple, but you will realize that many people do not have the ability to answer these questions as easy as you ask them, because their expertise might not be as good as you might want them to be. So, definitely ask this question. Look for a company with a proven track record in providing the services specifically to your practice and your specialty. I think that is very critical.
2. Another thing is HIPAA, How do they manage their security and compliance with HIPAA? It’s an outsourcing company. Nowadays, a lot of work is getting sent offshore. So you need to know that they are capable of handling that. They’re insured, they’re licensed, they’re bonded. So, you have to make sure of that.
3. What technology and software do they use for eligibility verifications? You’d like to know if they’re just doing only online verifications. Would they actually make the phone calls to the insurance company? Will they be able to work in your software or will they work only in their software?
4. Then comes the next question – what types of Insurance plans can you verify? Well, not everyone has experience in every insurance plan, so you need to make sure that these people have the experience that they claim they do.
5. What are the average turnaround times? Your practice might be a practice which requires quick turnaround time. You may have patients that come in quickly and you need to make sure that their eligibility is done immediately so you can make sure you see the patient. Well, if that’s the case, you need to ask that question as well.

 So, it is important to ask some of these questions.

03:17 Ask Questions That Are Specific to Your Practice

I know every practice is not the same. You have your ebbs and flows in terms of patients who come in. You might have a lot of walk-ins, you may not have a lot of walk-ins. So, you need to make sure that that is also taken into consideration.

Can they handle the patient volume fluctuation? That is important.

How about a question that is a little out of what a normal verification company might do.

How about you ask them – What do you do when… if there’s a problem with your verifications? We need to know how they handle their internal QA and how they handle their work. 

Do they provide reports? I mean, if it’s something that you have a very large volume, you might then like to know that they’re maintaining a certain amount of quality, and they’re doing internal quality audits, and you are getting the information that’s required.

 Of course, costs. I don’t think I need to go into that.

 Can you provide references, case studies? I think that’s an important question as well.

I think it is also important to cover, you know, other questions that might come up sometimes, such as – What do they do in terms of training? Do they provide continuous training to their staff? Is it something that they are very particular about? What about your specialty? How many staff do they have that can cover these specialties?

And then, “What do they do when there are potential inaccuracies or disputes that come from the insurance companies?” Now, we covered that a little earlier, but still it is a question that you would think that they know how to handle and they have handled because trust me, it’s happened many times before.

“What types of services and benefits do they offer beyond eligibility verification?” Why do you ask this question? You may not need anything beyond that, but it’s always good to know they have expertise in other areas such as Medicaid billing or collections, because your verifications is one of the main criteria that actually translate into problems that might happen in other areas. Do they know what they are? So, definitely ask that questions.

How do they onboard the new clients? This is a great question. Every company that you work with will be different. I’ll cover how we handle our onboarding in another podcast, but this is a question you definitely wanna ask.

Terms and conditions of the agreement – It is definitely important. Are they tying you up into a long-term contract? Is it a short-term contract? Is it month to month? What if you have only very small volume? What if you have a large volume? All these small details are important to cover when you talk to a company because you want to get the best service that you feel would appropriately help your practice.

You know, asking all these questions will help you assess the outsourcing company’s capabilities, reliability, compatibility with you and your medical practice. That so you can make a well-informed decision. It is essential to take the time to choose a trusted partner that can streamline your verification process, improve efficiency and hence overall patient satisfaction, your satisfaction, better collections, bringing money back into your practice. I think that’s important.

All right, there you have it.

Some of the advantages and that’s what I wanted to cover quickly today.

Next time I’ll cover on how an onboarding should happen in an outsourcing company, why it is important to make sure that that is conducted and properly done. We’ll go through our experience with our clients and how that has been very helpful for our clients. We continue to add clients and we look forward to having you back to listen to my next videocast, where we will cover how an onboarding will happen, how the practice will be assimilated into our processes and how it will help everyone.

Thank You!