Potential Pitfalls of VOBs
Main Points
Avoid guaranteeing the accuracy of your verification of benefits
Avoid generalities with the insurance company representatives
Avoid a lack of documentation when conducting a verification of benefits
As we come to an end in our series about verification of benefits, we want to leave you with some common pitfalls and how to avoid them in your practice. No process is perfect, but we hope that our series is able to help you gain better accuracy and clarity into your eligibility and benefits process.
Avoid guaranteeing the accuracy of your verification of benefits. Like we said in a previous post, about 1 out of every 3 eligibility checks tends to be inaccurate. That is a big number!
Knowing and understanding that eligibility checks are not perfectly accurate will help you when you are managing your patient's expectations. Use words and phrases that always maintain a margin for error. If you guarantee the accuracy of your eligibility check you will end up with frustrated patients when or if your eligibility check is incorrect.
You will want to repeat the phrase that the insurance company give you, which is that eligibility checks are a quote and don't guarantee payment.
Ultimately, it is the responsibility of the patient to know their benefits and pay for services according to the policies and guidelines set forth by the insurance company.
Avoid generalities with the insurance company representatives. Not all insurance company representatives are created equal. There are some representatives that are great at their jobs and you wish you could have their direct extension (believe me, we have asked!), and there are some representatives that make you want to bang your head against a wall.
One of the ways that you can avoid the frustration of the insurance company representatives is by being as specific with them as possible.
Give the reps your NPI and tax ID. Give the reps your patient's ID number, name, and date of birth. When they ask you what you are calling for give them the exact service and potential diagnoses that you are looking for.
Ask multiple follow-ups and don't feel pressured to get off the phone if the rep seems like they are in a hurry. They are on your time, not the other way around.
By avoiding generalities with the reps you will be able to get better information from them and better serve your patients.
Avoid a lack of documentation when conducting a verification of benefits. It is easy to want to rush through the eligibility and benefits check process, but that won't get you anywhere good. Pursue what is thorough and detailed through this process.
Write down the number you called, which extension you dialed, who you spoke with, and the reference number from the call. Detail what time you called and the content of your conversation. If necessary ask if you can receive a recording of the call for your records.
Be as detailed and thorough in your documentation as possible, including how much time eligibility and benefits checks take you. The more thorough you are and the more data you have the better.
You can use this information to discuss rate increases, train staff, help your biller with glitches, manage expectations, and get a better idea of how the health insurance industry works on a practical level.
Verification of benefits are very important and help your patient to feel as if they are paying for a luxury service. If done correctly, VOBs allow your patient to understand what they owe when they come into your office and will enable them to receive care for quite some time.
If your VOBs are consistently frustrating or inaccurate take a look at your process and see if there are any steps that you are missing or if you need to add any steps.
If you are becoming increasingly frustrated with VOBs feel free to reach out to us here and we would be happy to look at your processes and make any recommendations!
