Why is patient eligibility verification important before billing?

Verifying patient eligibility before billing is crucial primarily to ensure that the patient's insurance plan covers the services rendered. This process confirms whether the patient has active coverage, the specific benefits included in their plan, and the extent to which those services are reimbursable. By understanding what the insurance plan covers, healthcare providers can avoid submitting claims for services that may not be reimbursed, which could lead to financial losses for the practice and unexpected medical bills for the patient.

Effectively verifying eligibility also helps to streamline the billing process. It ensures that the correct information is captured before services are rendered, minimizing the risk of denials or delayed payments due to coverage issues. Ensuring coverage reduces the administrative burden on billing departments and enhances overall revenue cycle management, making it vital for the financial health of physician practices.