In the fast-paced world of healthcare, insurance verification is a critical yet often overlooked process that can make or break a practice’s revenue cycle.
Missed verifications lead to:
- Denied claims
- Patient billing disputes
- Lost revenue
In Edge’s latest webinar, “Navigating Insurance Verification to Streamline Your Medical Practice,” we brought together Dr. Jyothi Mamidi Juarez, a board-certified endocrinologist, and Laiba Bukhari, her remote Patient Intake Coordinator, to share real-world strategies for optimizing this process.
If you missed it, here’s your full recap with actionable insights.
Why Insurance Verification Matters More Than Ever
Dr. Juarez opened the session with a stark reality:
“8 years ago, I could look at an insurance card and say, ‘Specialist copay: $40—done.’ Now, even routine visits often hit deductibles. If you don’t verify upfront, you’re working for free.”
The Cost of Skipping Verification
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Unpaid deductibles – Patients may not pay after the visit.
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Surprise bills – Damages patient trust and leads to bad reviews.
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Staff burnout – Front-desk teams struggle with uncomfortable payment conversations.
The solution? Proactive verification—done 1-3 days before appointments—so patients know their financial responsibility upfront.
How Dr. Juarez’s Practice Transformed Verification
Before Remote Support:
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Relied on a billing company’s part-time verifier (10h/week).
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No real-time access when urgent questions arose.
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Frequent payment delays and disputes.
After Hiring a Dedicated Remote Coordinator (Laiba):
- 30-40% faster claim approvals
- Near-zero surprise bills (patients prepay based on verified costs)
- Staff morale improved (front desk no longer handles billing confusion)
“We stopped viewing remote help as a backup. They became an extension of our team.” – Dr. Juarez
The Verification Process: Step by Step
Laiba walked through real insurance portals (Availity, Cigna, UnitedHealthcare) to show how she:
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Checks eligibility – Is the plan active? Is the provider in-network?
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Identifies patient responsibility – Copay, deductible, or coinsurance?
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Flags testing costs – Will ultrasounds/labs go toward the deductible?
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Documents everything – Screenshots are shared with patients to avoid disputes.
Pro Tip:
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Color-code your schedule (e.g., red = missing referral, green = verified).
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Call insurers only when portals don’t show remaining deductibles.
Top 3 Verification Challenges (and How to Solve Them)
Challenge | Solution |
---|---|
“Copay shows $0, but deductible applies.” | Always check both copay and deductible sections. |
“Testing coverage is unclear.” | Call the insurer—don’t guess! |
“Patient says they met their deductible, but the portal disagrees.” | Wait 2-4 weeks for claims to process before collecting. |
Key Takeaways for Practices
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Delegate verification to a trained specialist – Front-desk staff often lack insurance expertise.
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Use portals first, calls second – Faster than waiting on hold.
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Collect upfront – If a visit is deductible-based, inform patients before they arrive.
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Audit past claims – Build a fee schedule so you know allowable rates for each insurer.
“Patients appreciate transparency. If they know costs upfront, they rarely complain.” – Laiba
Ready to Streamline Your Verification Process?
Edge’s remote healthcare talent are trained in:
✔ Insurance portal navigation (Availity, Cigna, UHC, etc.)
✔ HIPAA-compliant workflows
✔ Patient-friendly communication
Book a Call with Edge to see how we can help you reduce denials and boost collections.