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Insurance Verification Services

Bay Group Ventures, Insurance Verification staff, ensure that the patient’s health care benefits are covered for the required services, or even just an office visit. 

In the United States alone, it is estimated that healthcare administrative costs are $360 billion per year. This surpasses more than two times the amount spent on heart disease, and triple the amount spent on cancer. 

In order to collect payment for services, Physicians need to understand the coverage details. Bay Group Ventures can provide this service, allowing the Physician to know what is due & what to collect at the time of service, further cutting down on billing service costs. 

In a recent report, published by Managed Healthcare Executive, it is noted that 48% of denials arise from the patient access point and is often caused by the practice staff failing to verify coverage.

What we need to verify coverage:

  • Patient name & Date of Birth
  • Name of the primary insured
  • Social Security Number of the primary insured
  • ID & Group Number
  • Insurance company contact information, including phone number on the back of the card

After verification of details listed above, our office will then contact the insurance company via phone or portal to confirm the following:

  • Patient Coverage
  • Insurance Coverage Effective Dates
  • In Network or Out of Network
  • Co-Pay
  • Deductible amount/ whether deductible has been met for the year
  • Is the policy in danger of lapsing due to non-payment?
  • Finally- Based on visit- if any referrals or prior authorizations needed, we can obtain those as well.

Bay Group Ventures is here to perform insurance verifications, well in advance, of a patient’s scheduled visit. This allows Accounts Receivable the ability to communicate and explain information to the patients before they arrive for their appointment. 

If verification of insurance is not performed, this leads to increased billing costs along with administrative costs trying to address open claims by Accounts Receivable, and possible additional cost for collection services.

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