What is the process of checking a patient's insurance coverage before service is provided called?

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The process of checking a patient's insurance coverage before service is provided is known as eligibility verification. This crucial step involves confirming that the patient is eligible for benefits under their insurance plan, ensuring that services can be covered. It typically includes verifying the patient's personal information, the status of their policy, any applicable deductibles, copayments, and the specific benefits that apply to the services to be rendered.

Eligibility verification helps healthcare providers prevent issues related to billing or reimbursement later by establishing upfront whether the patient’s insurance will cover the treatment. This process can significantly enhance both the patient experience and the financial operations of healthcare facilities, as it reduces the risk of surprise bills and payment disputes after services have been rendered.

Considering the other options: claims filing refers to the submission of claims to insurance companies for reimbursement after services are delivered. Premium assessment entails evaluating the cost of the insurance premiums a patient must pay, which is not directly related to the verification of coverage prior to receiving services. Benefit coordination mainly involves determining which insurance pays first when a patient has multiple insurance plans, rather than verifying coverage for a single provider visit. Therefore, the most accurate term for the process of confirming a patient's insurance coverage prior to service is indeed eligibility verification.

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