Insurance Verification Form

Implement our insurance verification form template within your healthcare practice to elevate your processes. Intuitively designed, the form will save you time while improving data accuracy for reliable information input.

By Ashleigh Knowles on Jul 02, 2024.

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Fact Checked by Ericka Pingol.

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Insurance Verification Form PDF Example
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What is an Insurance Verification Form?

Managing insurance is an extremely important part of healthcare. Verifying a patient’s insurance plan refers to the process of confirming the validity and specific benefits of the coverage. Completing this process prior to the patient receiving services at your healthcare practice will help ensure that you get reimbursed at a faster rate. If you don’t validate your patient’s insurance, there is a much higher chance that the claims you submit will be denied, leading to a complicated and time-consuming billing process. To help healthcare practices improve their insurance verification procedure, we have developed a downloadable PDF form.

This can be easily accessed, stored, and distributed to patients when they first book an appointment at your practice. The verification form is separated into three clear and intuitive sections, allowing patients to quickly complete and return it so you can get in touch with the insurance provider. By using this form, you’ll be able to automate verification while also reducing the likelihood of experiencing claim denials – it’s a win-win!

Printable Insurance Verification Form

Download these templates for an insurance verification form to improve your insurance billing process and HIPAA compliance.

How To Use This Template For Insurance Verification Form

Although insurance is complicated, our insurance verification form template is not. In order to use it effectively within your practice, you simply have to follow this step-by-step guide:

Step One: Access the verification form

The first thing you need to do is access the insurance verification form. There is a link to the template on this page, which will open the document within a PDF reader. From here, you can download the form and save it to your device, where it can be used electronically or printed out into a physical copy. 

Step Two: Distribute the form to patients

When a new patient books their first appointment at your practice, you need to give them a copy of the insurance verification form. Enabling patients to complete this part of the process reduces the workload for you, while also allowing them to play a more involved role in their own care. You should encourage the patient to return the form to you in a timely manner, so you can validate the insurance prior to their first appointment. 

Step Three: Follow up with the information

After the patient returns the insurance verification form, it’s time to begin the validating process. There are a couple of ways that this can be done. You can get in touch with the insurance provider directly by contacting them over the phone, or if you’d prefer not to play phone tag you can also check online websites and directories for provider information. Many healthcare businesses also have automated verification software in place, which is another efficient way of validating insurance. 

Step Four: Input data to your system 

The completed insurance verification forms will contain information that should be uploaded into the EHR system that your practice uses. As soon as the insurance company validates your patient’s insurance plan, you should input this data into the client file so it can be accessed when it comes time to submit claims. Make sure you double (and even triple!) check that there aren’t any mistakes, otherwise you can expect your claims to be consistently denied. 

Step Five: Re-validate insurance

Although this step isn’t exactly a requirement, we would definitely recommend rechecking and revalidating insurance plans around once every year. Patients are encouraged to inform their care providers if they make any changes to their insurance plan, but people are forgetful and this is often overlooked.

Insurance Verification Form Example (Sample)

We’ve created an example insurance verification form with all of the different sections filled out so you can have a look at what the documents are like when completed. Although the information included in these forms will naturally differ according to your patient’s details, this example should give you insight into how they typically work.

Download this Insurance Verification Example (Sample) here: 

Insurance Verification Form Example (Sample)

Who Can Use this Printable Insurance Verification Form (PDF)?

We understand just how versatile the healthcare industry is, and have tried to ensure our insurance verification form caters to this. You may find that this template has additional sections that are less applicable to your patients and this is completely fine, you can just leave the unnecessary spaces blank. Some of the healthcare professions that will benefit from using the insurance verification form include:

  1. General Practitioners
  2. Nurses
  3. Counselors
  4. Psychologists
  5. Psychiatrists
  6. Physical Therapists
  7. Mental Health Therapists
  8. Dental Practitioners 
  9. Occupational Therapists 
  10. Speech Language Therapists
  11. Chiropractors

Why is This Form Useful For Clinicians?

When implemented within a healthcare practice, this insurance verification form will have a range of different uses, including the following:

Automates insurance verification

The primary purpose of these forms is to automate the insurance verification process. Distributing the form to patients prior to their first appointment will allow you to speed up the verification process and ensure that your practice has access to all the information required to submit accurate claims. 

Standardizes data collection

The data that you gather in the insurance verification form will be used every time that you make a reimbursement claim. As such, it is very important that the forms can be easily read and the relevant information extracted. By using a template, you can guarantee that data collection is standardized, making it much easier to read, organize, and manage client insurance.

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Benefits of Insurance Verification Form PDF

Insurance verification forms additionally have a number of different benefits, for individual practitioners, the practice where they work, and the healthcare industry as a whole. These benefits include:

Reduce the number of claim denials

Denied claims are one of the most frustrating things that healthcare practices have to deal with. And if your practice is experiencing a high volume of these, then utilizing insurance forms may be the perfect solution. These documents gather accurate data and allow practices to easily prevalidate a patient’s plan, ensuring that the claim contains only correct information. 

Reduce administrative workload

Without an insurance verification form, the process of validating a patient’s insurance is often left up to administrative staff. While occasionally this is fine, it can quickly become burdensome if you spend all of your time chasing down patients for missing information. Distributing the verification form to patients will save a lot of time at your practice, while having the additional bonus of getting patients more involved in their own care.

Improve transparency

Using the verification form will also help improve financial transparency. Receiving quality healthcare can be expensive and daunting for patients, and it is important that you are honest and transparent with them about costs during the care delivery process. One of the best ways you can do this is by prevalidating their insurance plan, so you can inform them of expected upfront fees early.

Optimize workflow 

Optimized workflows are the key to running an efficient and productive business. Using resources like this insurance verification form will reduce the amount of time patients need to spend in the waiting room as prevalidation will have already occurred. You’ll be able to stick to your schedule and ensure patients have a seamless experience at your practice.

Focus on your patients

All of these benefits work towards allowing you to spend more time and effort focusing on the needs of your patients. By getting the insurance validation out of the way before you initially see your patient, you’ll be able to spend more time developing an effective and responsive treatment plan.

Why Use Carepatron For Medical Insurance Verification Form?

Carepatron is a leading practice management software that can help your healthcare practice optimize its insurance verification processes. In addition to offering robust templates like this insurance verification form, Carepatron has secure storage capabilities and an integrated EHR. These systems work seamlessly together to ensure that your data can be created, stored, shared, and accessed without compromising patient privacy.

Additionally, Carepatron has developed automation tools that streamline insurance verification, as well as medical billing and coding processes. This type of automation will result in a lot of saved time for both administrative and clinical staff, which can instead be spent developing tailored care solutions for patients in need.

Medical billing and coding software benefit
What is the difference between insurance verification and prior authorization?
What is the difference between insurance verification and prior authorization?

Commonly asked questions

What is the difference between insurance verification and prior authorization?

Insurance verification refers to the process of validating a patient’s insurance plan with their provider. Alternatively, prior authorization involves obtaining permission for specific services prior to delivering these services. While both of these processes are very important in the healthcare industry, they have notable differences.

What are the questions needed to be asked for insurance verification?

The specific questions that are asked in order to verify insurance will differ depending on the services that you typically deliver to patients, but you should cover the following areas:

  • Can you confirm the patient’s policy, group number, the name of the policy-holder, and the relationship of the policy-holder to the patient?
  • Is this policy active? When is the policy’s end date?
  • What is the patient’s copay and/or coinsurance?
  • What is the patient’s deductible?
  • Do you require physician referrals, certificates of medical necessity, or pre-authorizations for reimbursement?
  • Are there any coverage limitations I should be aware of?
Why is insurance verification important?

Insurance verification is important for a few different reasons. It reduces the number of claim denials that your practice experiences by gathering more accurate data. It also helps to automate the billing process and will contribute to your practice receiving faster reimbursements.

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