“Playing nice” with insurance companies is one of your most important jobs as an addiction treatment provider. Organizations that master the art of interacting with insurance providers reap major rewards in terms of happy patients, strong revenue cycles, confident clinicians, and flawless documentation. Organizations that struggle with “insurance speak” grapple with angry patients, poor cash flow, unmet patient responsibility payments, and wary clinical staff. 

A strong Verification of Benefits (VOBs) game is the first key to “playing nice” with insurance companies. Today we’ll learn why VOBs are so vital to maintaining a well-oiled addiction treatment organization and what you can do to fine-tune your systems to leverage great Verification of Benefits at your organization.

If Your VOB is Done Poorly (or Not at All!) Your Rehab Doesn’t Get Paid 

VOBs are the first link in a chain of billing events that lead to successful reimbursement, great cash flow, and strong revenue cycle management. 

A poorly done VOB puts your relationship with the insurance company off to a bad start.  

It’s important to realize that a VOB is not the same thing as a verification of patient coverage. A verification of patient coverage merely tells you if the patient is “active” with their insurance and up to date on their premium payments. A true VOB will tell you much more, including how much the insurance provider will pay for services, which services are covered, and how those services need to be billed in order to maximize insurance reimbursements. 

True VOBs need to be done before any patient care begins to avoid any billing mishaps that could lead to insurance denials. Anything that becomes “patient responsibility” is going to be much harder to collect than insurance reimbursements, leading to delayed payments, unhappy alumni, and challenged cash flow. 

Skimpy VOBs Lead to More Addiction Treatment Insurance Denials 

Skimpy VOBs are any verification of benefits where some element of the insurance company’s coverage was not communicated and documented. Skimpy VOBs mark the VOB checkbox as “done” but they leave critical details out of the VOB picture. This often happens when inexperienced or overwhelmed staff are tasked with completing VOBs. 

It’s also not uncommon for insurance companies to give inconsistent or incorrect information during a VOB. 

When details are missed during VOBs, the end result is an increase in insurance denials. Common denials from incorrectly executed VOBs include:

• Service Requires Prior Authorization 

• Coverage Terminated or Member Not Eligible on This Date of Service

• Services Performed Are Non-covered

• Maximum Benefit for This Service Has Been Met

• Patient’s Insurance Plan Has Changed 

• Patient’s Coverage is Inactive

• Provider is Out of Network 

At BehaveHealth, we have strong relationships with insurance providers and we can spot VOB inconsistencies before they become a problem. We know addiction treatment policy at every major insurance company and we know what to expect in terms of which claims will be successful and whichwill be denied, regardless of what the insurance company might incorrectly claim during a VOB interaction. Our expert revenue cycle management services have helped many addiction treatment centers conquer VOB struggles and get cash flow back on track. 

Good Addiction Treatment Customer Service Starts with Rock-Solid VOBs

A true VOB needs to be done before any services begin for the patient. That’s because if you bill an insurance company without doing a VOB first, there’s a very good chance that the claim will not be successful. If the claim is denied, the payment becomes the patient’s responsibility.

Services rendered on a patient responsibility basis—also known as “self pay”—are much harder to collect than properly billed insurance reimbursements. Patients often don’t understand why they should have to pay for services when they “have insurance” and are current on their insurance premiums. You want to avoid being the bearer of bad news to patients by always completing a robust VOB before rendering any services to the client.  

Letting patients know what to expect from their insurance provider ahead of their time with your organization is good customer service. Setting up clear expectations at the beginning of your relationship with patients lays the foundation for trust, a necessary ingredient in any addiction treatment program. 

At BehaveHealth, we make your patients feel “taken care of” by every aspect of your program—including the billing department. 

Without a Strong VOB, Everything Else at Your Addiction Treatment Center Suffers 

Mastering the art of verifying insurance benefits sets the stage for easy coding, billing, utilization reviews and, if necessary, insurance claims appeals. A smoothly operating billing department ensures strong cash flow at your business and keeps you on track for meeting your financial goals. 

You don’t have to do it alone. Contact BehaveHealth today to set up your free trial of our all-in-one cloud based revenue cycle management system especially tailored to the unique needs of behavioral health providers.