Verification of Benefits for Physical Therapy, Occupational Therapy and Speech Therapy

Everyone knows that verifying a patient’s benefits before seeing them is crucial. In fact, eligibility errors are the number one reason a claim is denied!

The first step is gathering the necessary information from the patient. 

Once you have all of the necessary information, you can begin the process of verifying patient eligibility and benefits. 

Unfortunately for physical therapy, occupational and speech therapy benefits, you have to call the insurance company. Provider portals and clearing houses rarely provide authorization requirements and usage of limitations which is important for you to know.

Before you call the payer, you can at least use Availity or other portal to check:

• Is the insurance active?
• What is the deductible and out of pocket max? What’s remaining?
• Is there a copay or coinsurance?

After you gather the information you can from online portals, you are prepared to call the insurance company to complete the verification.

Below are some pieces of information you want to ask the payer about:

• Referral requirement
• Pre-authorization requirement and how to submit authorization
• Limitations 
• Patient responsibility

If you are interested in learning how One Body can help you and your office with verifying your patients’ benefits, please fill out the contact form below.