Certified Revenue Cycle Representative (CRCR) Practice Exam

What is the main purpose of insurance verification?

1. To ensure accuracy of the health plan information

2. To identify information that does not have to be collected from the patient

3. To complete guarantor information if the guarantor is not the patient

4. To establish prior medical history before treatment

The correct answer is: To ensure accuracy of the health plan information

The main purpose of insurance verification is to ensure accuracy of the health plan information. This process involves confirming the patient's insurance coverage, benefits, and eligibility for the services they will receive. Accurate health plan information is crucial for billing and coding, as it dictates what services are covered, the patient's financial responsibility, and ensures that the healthcare provider will be reimbursed for the services rendered. If this information is not verified correctly, it can lead to claim denials, delayed payments, and ultimately financial loss for the healthcare provider. By validating this information upfront, practitioners can streamline the revenue cycle process and provide better financial transparency and service to patients. While identifying information that does not need to be collected, completing guarantor information, and establishing prior medical history are also important aspects of the patient intake process, they do not encompass the primary goal of insurance verification, which focuses specifically on confirming the accuracy and completeness of insurance-related details.