Crews collect insurance in hallways, in moving trucks, and from patients who are having the worst day of their lives. It is no surprise that a lot of charts come in with no insurance, or the wrong insurance.
That does not mean the patient is self pay. It means somebody has to go find the coverage.
Where coverage hides
- The hospital facesheet. If the patient went to an ED, the hospital usually has better insurance information than the crew did.
- Eligibility checks. With a name and date of birth, real-time eligibility checks can confirm or find active coverage with major payers.
- Prior encounters. If the agency transported this patient before, the last claim may already have the answer.
- Other coverage. Auto, workers' compensation, and liability policies can be primary, and they are easy to miss.
Do it before the statement goes out
The worst outcome is sending a bill to a patient who had coverage all along. It hurts collections, and it hurts how your community sees your agency.
In LifelineIQ, coverage checks run on the claim before it moves forward. The biller sees what was found, where it came from, and decides what to bill. Patients only get a statement when we are confident it is actually theirs to pay.