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The “Benefits” Of Checking Patient Benefits


Have you ever found yourself shocked in disbelief after opening a bill from one of your medical providers? You have insurance and you pay a monthly premium but your insurance company still did not cover the services that you were provided. Sound familiar?

Unfortunately, many patients do not have a good understanding when it comes to their insurance terms and/or benefits. They sign up for a new plan but never take the time to actually read over the policy and know whether they have a deductible, coinsurance, copay, visit limit or out of network benefits just to name a few. Instead, the only thing they seem to really know how much they have to pay each month for their premium. 

In the fast paced healthcare environment we live in, most medical providers do not take the time to check their benefits because they feel that it is ultimately the patient’s responsibility to know and understand their policy. However, I believe that there are a number of advantages to checking benefits for your patients:

  1. No surprises! Patients are aware at their first visit if they will have any patient responsibility.
  2. Payment Plans can be set up for patients who may have financial hardship which will significantly increase your likelihood of getting paid. 
  3. Visit limits can be determined and a plan of care can be designed to coincide with the limit. 
  4. Effective date of policy can be confirmed to ensure that the patient does have coverage.
  5. If you know their benefits, you can collect their deductibles, coinsurance and copays up front!

During the patients first visit, I highly recommend that you take the time to review their benefits in detail so that they can ask questions and have a firm understanding of their financial responsibility. Taking a few extra minutes to do this will not only secure patient payment but it will also help to develop a positive rapport between your office and the patient. 

Think about it – would you be impressed and very appreciative if a medical provider took the time to check your benefits and outline what your financial responsibility was going to be prior to treatment?

So my recommendation to you is this – do your patients a favor and check their benefits. If you take this extra step, I guarantee that you will also see the “benefits” in your bottom line.

If you would like to learn more about checking benefits or if you would like us to check your patient benefits for you, please do not hesitate to contact us.

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