Verification of Benefits (VOB)

  • Updated

The VOB Work Center allows users to keep track of patients that require verification of benefits. Verifying benefits is an important step in the collections process. It provides insight into expected coverage and increases claim accuracy. Use the tracking, organization, and recording features in AveaOffice to streamline the VOB process.

Workflow

The VOB workflow begins when a prospective or admitted patient has insurance and policy holder information added into AveaOffice. For assistance with this please see How to Add Insurance. Once insurance information is saved, the patient will appear in the Management Center VOB tiles.

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Clicking into one of these tiles navigates to the Work Center in the VOB tab. This dashboard updates every 15 minutes, to give an accurate depiction of which VOBs are over and coming due.

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To enter VOB details for a patient, click on the blue VOB link next to the patient's name. This will automatically navigate you to the patient's Benefits tab, located in the patient's Insurance Set under the Treatment Episode's Intake section. 

 

Information received from the payer is entered here. Having a record of benefits is useful when assessing covered amounts and making admissions decisions. The Benefits tab will auto-populate with patient demographics entered in the patient’s Intake tab.

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Select the assigned VOB user, date of verification, representative name and reference number. Switching Benefits Successfully Verified to Yes and saving the page will remove the patient from the VOB Center list of items to be followed up on.

Plan Information: Fill in policy details regarding accumulations, pricing structure, submission information, plan requirements and restrictions. The Pre-Auth Company and Phone Number entered in this tab automatically saves to the patient’s Scheduling and Utilization tab.  

Coverage Breakdown: Active services for the practice are listed. The service list can be used to record coverage and covered percentages for treatments the patient may receive.

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For each relevant treatment, the VOB team should record whether the service is covered, requires a pre-auth, what percent, if any, is applied to coinsurance, if there is a maximum number of treatments that will be covered, and how much of that benefit has been used.

Policy Notes: Use this section to record any extra details obtained from the verification. This may include unique features of the plan or exclusions based on diagnoses and coding.

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Once all the information is entered, click Save. The VOB form can be downloaded as a PDF after completion and will include the Patient's profile and policy data. 

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Important: If Benefits Successfully Verified is set to No when the page is saved, the policy will NOT be considered verified and will remain in the VOB Center. If benefits have been verified, to remove the patient from the VOB center, switch Benefits Successfully Verified to Yes and save.

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