All insurance providers operate differently, and figuring out what is covered or not can be extremely complicated. Even people who call in to make sure something is covered, could end up with a big bill when it's all said and done. In more urgent cases, the entire treatment might be over before you find out if it was covered by your insurance plan.
Some organizations, such as Perry, are trying to make the process easier for patients and the billing staff. Certain employees are tasked with coordinating with insurance providers through pre-authorizations. They verify that the orders received are going to be covered, track the visits, and work with physicians to ensure everything is charted to ensure the treatment meets the expectations of insurance. They communicate with insurance often to keep the patient and family informed about the process and to let them know if there will be a fee for certain services. Starting even before a patient is admitted or makes their first visit, these staff start the process as soon as possible to stay ahead of any curve balls.
On this episode of the Pulse, Michelle Kinnamon and Sara Lucas share their experiences securing authorizations from insurance providers and making the patient experience even better.