Insurance Verification & Financial Fit
Transparent, HIPAA-aligned verification that helps patients understand their coverage and facilities admit confidently.
Overview
Insurance clarity builds trust.
Our team verifies behavioral health insurance coverage quickly, accurately, and compliantly — so your admissions staff can focus on helping patients instead of chasing policies.
We contact insurers directly, confirm benefits, and provide a transparent coverage summary that sets clear expectations before admission.
With MIMC’s financial-fit process, you minimize billing surprises, reduce drop-offs, and protect your facility’s credibility from day one.
How it works
How Our Process Works
Every verification step is structured, compliant, and fully documented — ensuring financial transparency for both patient and provider.
1
Consent & Data Collection
We obtain verbal consent and gather only the minimum necessary information for verification.
2
Insurance Verification (VOB)
Our trained staff contact the insurance provider to confirm active status, policy type, and behavioral-health coverage.
3
Coverage & Benefit Summary
We outline deductibles, co-pays, out-of-pocket maximums, and pre-authorization requirements.
4
Financial Fit Assessment
We match the financial profile to your program’s criteria and prepare a clear summary for your admissions team.
5
Transparent Handoff
Results are securely transmitted to your admissions coordinator, ready for scheduling or follow-up with the patient.
Qualification Criteria
What We Verify
Our verification and financial-fit process covers every key aspect your team needs before an admission decision:
- Policy and plan type confirmation
- Active/inactive status verification
- Mental health and substance use coverage limits
- Deductibles, co-pays, and OOP maximums
- Pre-authorization requirements
- Network and benefit eligibility
- Payment responsibility overview
Our focus: clarity for your team, transparency for the patient.
Compliance
Compliance You Can Trust
All insurance verifications are handled under strict data security and compliance protocols:
- HIPAA Compliant: Minimum necessary data, encryption, and limited access.
- 42 CFR Part 2 Aligned: Safeguarding patient confidentiality in substance-use related coverage.
- TCPA/CTIA Safe: Consent-based outreach for all follow-ups.
- No Patient Brokering: No sharing or selling of data—ever.
Each verification is timestamped, logged, and auditable for your peace of mind.
For more information, see our Ethical Intake & Marketing Code.
Ready to Grow Your Admissions Ethically?
Let’s talk about how MIMC can extend your admissions team and drive compliant census growth.
No commitments. Just an honest conversation about your goals and compliance needs.
Outcomes
Outcomes You Can Measure
Insurance verification isn’t just an administrative step — it’s one of the biggest factors influencing conversion and trust. By clarifying coverage early, you eliminate uncertainty for patients and staff alike. The result is a smoother intake experience, fewer billing disputes, and stronger, more transparent relationships with payers and families.
- Reduced admission delays — admissions move faster when coverage is confirmed before scheduling.
- Higher patient confidence — financial transparency builds trust and commitment.
- Improved payer mix — qualified, verified coverage improves your revenue cycle.
- Fewer surprise costs — patients and families understand their responsibility upfront.
- Audit-ready documentation — every verification is logged, timestamped, and easy to trace.
Every verified policy equals fewer surprises, faster admissions, and greater peace of mind.
Connections
Integrations & Handoffs
We integrate directly into your workflow — GHL, Salesforce, HubSpot, or your in-house CRM — to ensure verified data flows seamlessly.
All transmissions are encrypted and access-restricted under your signed BAA.
Whether you need warm handoffs or shared-document uploads, our process adapts to your team’s preferred system.
Use Cases
Our Insurance Verification & Financial Fit service supports a wide range of behavioral-health programs, from single-site detox facilities to nationwide multi-level networks. Regardless of your size, we tailor our process to your clinical structure, billing systems, and compliance requirements.
- Detox & Residential: Confirm coverage and co-pays before transport or arrival to avoid last-minute denials.
- PHP / IOP Programs: Identify partial and outpatient benefits, and ensure pre-authorization compliance.
- MAT Clinics: Verify recurring medication and follow-up visit coverage with accurate payer limits.
- Multi-Facility Networks: Standardize VOB workflows across multiple admissions teams to improve efficiency and reduce verification time.
FAQs
Frequently Asked Questions
Yes — our specialists contact insurers by phone and document all verification details for transparency.
We flag pre-authorization needs and provide all necessary information, but final authorization remains with your clinical/utilization review team.
All information is handled within HIPAA compliance standards — encrypted storage, secure transmission, and restricted access.
Absolutely. We can push verified data directly to your CRM or shared workspace.
Patient consent, basic policy details, and your facility’s coverage acceptance criteria.
Getting Started
What We Need From You
To get started, we simply need:
A signed Business Associate Agreement (BAA)
Your admissions and billing criteria
List of accepted payers or networks
Access method for secure data transfer (CRM, portal, or shared drive)
Once we have that, our verification process is live within 48–72 hours.
Ready to simplify verification and improve financial transparency?
Let’s discuss how MIMC can streamline your verification process and improve admission efficiency.