To easily verify a patient's insurance coverage, it is important to understand key details of their health insurance policy such as identifying the covered person, knowing the policy and group number as well as whether the policy was active when services were received. It is also necessary to confirm if the procedure is covered and has any pre-approval requirements, understand any co-payments due like deductibles or copays, and be aware of the process to appeal any denied claims as outlined in the policy.

1. The key roles of understanding of
insurance policy for easy Patient
Verification

2. Understand the Health Insurance
Policy
• Identify the Covered
Person - Was the recipient
of the provider’s services
covered by the health
insurance policy?
• Know Your Policy Details -
What is your insurance
policy and group number?
Was your policy in effect at
the time the services were
provided?

3. • Confirm That the Procedure
Was Covered and Approved
- Was the procedure
directly or indirectly
covered in the policy terms?
Was prior authorization or a
second opinion required? If
so, did you meet the
requirements?

4. • Any Co-Payments Due.
What is your deductible?
How much is your Copay?
Do you have evidence of
your payment? Policy
holders often forget there is
usually a shared payment
responsibility until policy
maximums are met.

5. • Understand the Appeal
Procedure Detailed in the
Policy. Your health
insurance policy has a
complete section describing
how to question a denied
claim, often with detailed
forms, phone numbers, and
websites.

6. Thank You!
For more details
Check
https://www.pverify.com/