What should be the action taken if a Patient Access Specialist finds a discrepancy in insurance information?

When a Patient Access Specialist encounters a discrepancy in insurance information, the most appropriate action is to investigate the discrepancy and verify the information. Ensuring that the insurance details are accurate is crucial for a number of reasons, including the facilitation of timely reimbursements and preventing potential billing issues that could arise from inaccurate information. By addressing the discrepancy promptly, the specialist can also enhance the patient experience by avoiding confusion or delays in treatment.

Investigating and verifying the discrepancy allows for a thorough reconciliation of records, which not only protects the patient’s financial interests but also ensures the healthcare provider is operating under correct and current information. This diligent approach sets a foundation for effective communication with both the patient and the insurance company as needed.

Proceeding with registration without resolving the discrepancy could lead to complications later on, such as claim denials. Directly reporting to the insurance company may not be effective without first confirming the details with the patient or confirming the information against official documentation. Contacting the patient to confirm financial specifics is often a part of the verification process, but the primary step should be a comprehensive investigation into the discrepancies identified.