Verification of Benefits
A proper verification of benefits is an essential step in billing insurance. It provides the foundation for proper coding and billing, as well as appealing denied claims when it becomes necessary. Learn ACA's clinic managment series takes participants through the steps of verifying benefits, giving examples of what to look for and the questions to ask, and highlighting specific scenarios, including instances when special questioning may be necessary. This course is intended for anyone whose work focuses on clinical administration: CAs, claims billers and coders, office managers, and doctors.
· Verification of Benefits: Understand the necessary components of a properly executed verification of benefits and know instances when certain special questioning is needed.
· Appeals: Understand the importance of appeals (including ERISA) and the basic process and follow through needed for optimum chances of overturning a denial.
· Self-Audits: Be able to apply the information provided in order to help ensure necessary components of medical records are in place and self-audits are performed.
· HIPAA: Be able to identify whether their clinic is in compliance with HIPAA’s basic changes, and will understand both consequences of a breach and notification requirements.
· Provider contracts: Be equipped to confidently review and understand essential portions of provider contracts and what questions to ask of payers.