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3 Tips When Checking Eligibility


Checking eligibility and benefits can be a hassle. There are times where you can spend 15 minutes checking eligibility and benefits or several hours for one patient. There are many factors that can impact the speed at which eligibility can be checked.

If you follow these three tips you can greatly increase the speed at which eligibility checks can be accomplished.

1. Get a Copy of the BACK of the Insurance Card

Many providers think that the front of the ID card is sufficient for checking eligibility and benefits, but this is incorrect. It is the back of the ID card that provides the correct phone number one should call to check eligibility and benefits.

If you call the local office for eligibility and benefits, you may get transferred or even obtain the wrong information for the patient. Make sure you call the number on the back of the specific card.

2. Be Prepared

When checking eligibility and benefits, the phone system is going to require some standard information. Be sure you have the patient's name, date of birth, address, and insurance card. Also, make sure you have your NPI or tax ID along with the service address.

Without any of this information, the process will be hindered greatly. One great way to ensure this information is available is by employing a simple to use EHR. Don't waste time searching for this information while on the phone.

3. Be Patient

Of course, waiting on hold is frustrating, but sometimes necessary. One thing that helps here is to be patient, but also to ensure a smooth call the next time, document each step on the call for each payer. This will avoid any unnecessary repetition.

One final tip: have something else you can work on if you are checking eligibility. This is a good time to multi task while on hold.


Eligibility checks are important to avoid late or incorrect payments from patients. They can greatly increase a practice's cash flow, but they are time consuming at the same time. By being prepared and staying patient, these can go by smoothly.


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