Eligibility and benefits can be confusing, even when it’s supposed to be simple. The last thing you want is to be surprised by a mandatory prior authorization or a diagnosis code exclusion. If you’ve been blindsided by these things or you have no clue what I’m talking about, then you probably need to use my cheat sheet when calling to verify insurance eligibility.
Just call the insurance company and follow this step by step workflow to get most if not all the answers you need. While you’ll probably never catch every trap that insurance companies use to deny your claims, this will help you get more accurate eligibility verification for your patients.
