Most practices don’t realize how an effective verification process impacts everything else. When checks go smoothly, appointments run on time. When they don’t, the entire day goes off-course. It’s one of those behind-the-scenes functions that either supports the practice without anyone knowing or creates issues that no one prepared for along the way.
Verification efficiency might not seem directly related to revenue at first. But what happens is this: proper verification means fewer denials down the line, and fewer denials mean faster payments. Faster payments mean increased cash flow. It starts in motion as soon as someone checks the patient’s information.
What Happens Pre-Appointment
The verification stage sets everyone up for success or failure moving forward. Team members reach out to payers to confirm active coverage, assess benefit questions, and determine if there are any necessary authorizations. This process informs the team whether they will get paid for the services rendered.
The longer it takes to verify, the longer patients wait to confirm and keep their appointments. The more time front desk teams spends on hold with payers and without paying patients in front of them, the more time clinical teams try to plan a day without knowing if appointments are locked in. In fact, many practices rely on remote insurance verification support to manage this function faster so that their in-house teams can focus on those patients already present in the office.
This only gets compounded when a team attempts verification on the day of. That’s when they find out from the payer that coverage isn’t active, or certain policy numbers or group numbers are missing, or an authorization required was not submitted. All things that should have been caught days prior.
The Undiscussed Revenue Impact
Clean claims get paid faster. It’s that simple. But they need effective verification to ensure they qualify as clean claims. This means that when staff get the opportunity to verify coverage specifics, copays due, and treatment options within the plan, no one is missing reimbursement opportunities down the line.
Denials that occur mean someone now has to research why it wasn’t paid. They will need to fix that claim and resubmit, again, without getting paid for claims they rendered weeks before. Some denials will never be overturned, and the practice must accept that amount.
Denials also mean having uncomfortable conversations with patients who get unexpected bills because their insurances weren’t properly verified, or they were, and incorrect documentation was submitted. This takes time away from staff who could be helping others, and it hampers the patient relationship.
The Daily Operations Impact
Practices that have this down pat tend to function differently. Their schedules remain more predictable because appointments aren’t cancelled last minute due to insurance problems. Staff aren’t continually inundated with issues during the day that should have been fixed before the appointment. The billing team submits cleaner claims from the get-go.
More often than not, these practices are verified several days before appointments, not on the day of. They have clear paths of what happens when a policy is inactive, or gaps exist, and better note what takes longer for verification, so someone can follow up with that process later.
The curious component is patient perception when processes are more efficient. When appointments run on time, and billing is easy, patients know it. They’re not sitting waiting on their appointment while staff run around scrambling to verify coverage. They’re not getting confusing bills months after they leave.
The Staff Time Effect
Front desk staff tend to manage the verification process along with everything else, namely answering phones, checking patients in, scheduling future appointments, and managing documentation coming from all angles. When verification doesn’t happen quickly enough, something has to give. Either patients sit at check-in for 15 minutes longer than necessary, phone calls go unreturned until someone has a minute, or they rush to get verification done without sufficient information, just to say they made an effort.
Some practices document how many hours per week their front-line team spends dedicated just to verifying insurance status, and it’s surprising. A practice seeing 100 patients a week might spend 15-20 hours dedicated just to these phone calls, which means half of a FTE devoted just to this function.
It doesn’t help anyone to cut this time into smaller segments throughout the day since the task still needs to get done, but it means people are interrupted multiple times instead.
What Better Cash Flow Means
Once practices tighten up their verification processes, payments tend to improve within one or two subsequent billing cycles. Denial rates decrease as does the time between service renders and payment receipt. The accounts receivable aging report becomes far more doable.
These changes don’t equate to increased revenue from new services; instead, they clarify what the practice deserves for work already rendered. Most practices would be surprised at how much revenue could have been saved, had avoidable mistakes not prevented proper payments.
Cash flow becomes more predictable over time, which makes financial forecasting easier; practices can bank on monthly predictions with less frequency of denied claims or corrections needed for payment.
Implementing Change
Improving this process doesn’t require buying new software or overhauling how a practice runs; instead, it acknowledges why verification deserves its own attention during the day, not shoved in between other tasks, and when it’s viewed as a priority, significant improvements are made both for patient flow and revenue collection purposes.
The goal isn’t perfection, it’s reliability. The more accurate verification can consistently happen, the easier everything else becomes for everyone involved. Better quality patient services, reduced stress for in-house teams, and increased collections for what the practice deserved made everyone happy in the end.
