Insurance cards are a common and expected part of the medical billing transaction process. Patients assume every visit to their doctor will begin with an insurance card being shown. Unfortunately, insurance cards are not the infallible information providers that they should be.
Gaps of information can hurt your bottom line. Every time an insurance claim is filed with incorrect or incomplete information, a denial is sure to follow. Denials are not just annoying; they are time consuming. And what is time consuming in a medical practice is also revenue draining by default.
One piece of information that can particularly be hard to find is the payer ID. The payer ID, also known as the electronic data interchange (EDI) ID, is a coded sequence assigned to each insurance company that allows provider and payer systems to talk to one another to verify eligibility, benefits, and submission processes. The payer ID is generally (but not always) five characters long and may include letters, numbers, or a combination of both.
The location of the payer ID on the insurance card varies. In most cases, it is on the back of the card in the provider or claims submission section, but not always. Since this number is an important piece of information to complete the claims process, you would think that every insurance card would include and clearly identify it. Sadly, this is not the case.
In some situations, billing staff members need to hunt down and record the payer ID through a Web search or interaction with the insurance company. This extra step can add one more opportunity for human error in the process. To combat this, some medical practices have purchased optical character recognition (OCR) software and have integrated it into their check-in process. OCR essentially takes a picture of an insurance card, extracts the data points, and then populates the office database for claims processing.
An OCR can be a huge time saver for the office staff, but not all systems are created equal. When choosing an OCR, make sure that the software has advanced artificial intelligence (AI) algorithms that will help to fill in the gaps of missing information—particularly payer ID. Just like any equipment purchase, be smart about OCR selection. Make sure it will help streamline your medical practice’s efficiency.