It’s time to plan for January 1st verifications
The end of 2023 is around the corner which means new year verifications are coming up next!
Many clinics and front desks say the beginning of year is the most stressful time of the year due to several reasons:
- Many policies go inactive
- Many policies reset in January and have different requirements from last year
- May patients get new policies and don’t tell you
If policy changes go undetected it could lead to thousands of dollars in lost revenue so it’s imperative to plan for January.
Below are some tips on how to prepare for new year verifications:
1) Make a list of patients you need to verify
Some EMRs make this really easy by allowing you to download a report of all patients. You can filter this patient list by all active patients (not discharged) or you can filter all patients with a future appointment set in 2024.
2) Sort patient list
Sort the patient list by appointment date. The phone lines and wait times are always busiest the first 2 weeks of January therefore you want to call/check verifications in order, by the earliest appointment date to the further out.
3) Make a list of payer phone numbers
Put together a spreadsheet of all the payer phone numbers you can so you have access to it.
4) Call patients in December
If you can, you should start calling active patients or asking them in person in December if they will be getting new plans. Since open enrollment is in November/December they should know if they are getting a new policy or are keeping their existing policy. While you shouldn’t take their word for it, it is helpful when a patient tells you their policy is changing.
5) Set up an automated mass email or text campaign on January 1st
Schedule a mass email/text to go out for patients to send you their new insurance plan or provide you with new insurance information. Not all patients will answer, but any that do may save you some time.
6) Put together a plan for January 1st
Portals – Before you call payers, check Availity or any other portals you have access to to check if the policy you have on file is active.
Patient calls – If the plan you have on file is not active, call or email the patient asking for an updated insurance plan.
Payer calls – It’s important to call payers and confirm everything (i.e visit limits, deductibles, preauth requirement) for the new year. Payers sometimes change things year to year.
7) Hire extra sets of hands
Calling payers the first 2 weeks takes extra time. Longer wait times and inexperienced reps will cause delays in getting the right information regarding the eligibility of your patients’ benefits. If you can, it’s best to hire extra help for that month or have some internal staff dedicate extra time to verifications.
8) Know which portals have complete information in case you don’t have time to make calls
There are some portals that you can rely on to have more complete information than others.
Some insurances we have found to have complete information online:
- Medicare
- Florida Blue
- Tricare East
- Some UHC plans
If you need help verifying your patients’ benefits, One Body can help. One Body works with hundreds of clinics to help them verify their patient benefits. We are a US based team with 30+ years experience verifying benefits. We call payers for you and provide you with comprehensive verification of benefits reports so you have everything you need before seeing patients. Our goal is to provide you with comprehensive, accurate and timely verification of benefits reports. If you are interested in learning more, please contact Eva at eva@onebodywellness.com or go to www.verificationofbenefits.com.