When should insurance eligibility be re-verified?

• A. At check-in prior to service and when there are changes to plan or patient demographics, per policy.
• B. Only at initial enrollment.
• C. Only after service completion.
• D. Insurance eligibility is never re-verified.

Answer: (A)

Insurance eligibility should be treated as an ongoing check that confirms the patient has active coverage with current benefits right before services are provided. The best practice is to re-verify at check-in prior to service and whenever there are changes to the plan or patient demographics, per policy. This keeps the payer’s requirements in sync with the patient’s actual coverage, ensures accurate copay and coinsurance amounts, and helps prevent claim denials due to outdated information. Relying only on initial enrollment can miss mid-year changes in plan or patient data, waiting until after service is too late to prevent issues, and saying re-verification isn’t needed isn’t accurate.