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Verification of Benefits 101: who, what, where, when and why?

A verification of benefits is the first vital piece of admitting a patient to your facility.  If they don’t have benefits for the treatment they receive, there will be no reimbursement. There are a number of things that can be found out on a verification call; information about patient responsibility, what services are covered, etc.  

Insurance payers aren’t obligated to voluntarily hand out needed information which is why it is important to know what questions to ask.  Behavioral Health benefits have historically been low on the totem pole and until the Parity Act, some payers actually excluded coverage for substance abuse treatment.  Coverage for addiction treatment has come a long way in the last 10 years, but it can still be difficult to get the correct benefit information without asking the right questions.

In the age of technology, there are emerging tools that promise to provide everything you could want to know about insurance benefits with just the click of a button.  While that sounds like a wonderful thing, it can be a bad idea to rely on just the electronic information. Sometimes, the payer database isn’t regularly updated and it is possible that you would get more up to date information by speaking with a representative.  Additionally, there is a wealth of other information that could be important that you can only find out by speaking with a live person.

The bottom line is that even though it can take time and may cause frustration to speak to a representative, it really is an essential part of the admission process.  Without it, you may be faced with unwanted surprises.

Get your free trial started today and see why more addiction treatment centers prefer Behave Health.