The pros and cons of Electronic Verification of Benefits

Many EMRs have a feature that will allow you to check benefits. These features pull information directly from payer portals and are all about speed. They can help you find out information related to your patients’ benefits in a matter of minutes.

Unfortunately there are drawbacks to using eVOB (electronic verification of benefits).

Pitfalls of eVOB

• Registration – signing up for a new portal may require you to fill out a bunch of information, register and then wait for approval.

• Incomplete information – payer portals are designed by the insurance companies and they get to choose what information to include online. Unfortunately this made lead to you not knowing all the information you need to know before seeing the patient

• Confusing data – the information on payer portals is not always clear nor easy to interpret. For example, a patient may have a tiered plan and you will see benefits for all the tiers but not have the ability to see which tier you are in. Or perhaps the patient has physical therapy benefits in the office, outpatient setting, facility setting and at a preferred provider rate. You might not know which applies without calling.

• No ability to ask questions – When the information is unclear or simply not present there is no one to clarify that information. In these cases you will have to then call the insurance in addition to checking the portal and will have to spend even more time on this verification.

• No proof – should the information change from the day you verified the patient’s benefits and when you hear back from the insurance company regarding the claim you filed, there is no reference number to refer back to for an appeal. A call to an insurance company will always yield a reference number for the call. 

If you need help verifying your patients’ benefits, One Body can help! Clinics just like yours outsource verification of benefits to us so they don’t have to wait on hold or deal with interpreting the information given by payers. One Body does that for you. We provide you with a comprehensive, easy to understand benefits report so you know everything about the patient’s responsibility and the payer’s reimbursement requirements before seeing the patient. Fill out the contact form below or email us at hello@onebodywellness.com for more information!