Depending on the size of your health care facility, or whose management you’re under, you may have a team of insurance and compliance employees who handle payment and insurance issues and are adept at managing and processing claims with the insurance companies. But if you don’t, there are some important procedures to follow that will help you facilitate this fundamental part of running a health care office.
Our Staff will contact the patient’s health insurance carrier to get the following information for medical eligibility checks:
- Patient is indeed covered by the insurance
- Insurance coverage effective dates
- In-network or out-of-network coverage
- Service(s) you are seeing the patient for are covered. Do they need pre-authorization and/or a referral by a primary care physician?
- Amount of co-pay for services, if any
- Deductible amount–has the deductible been met for the year?
When the patient arrives for their appointment, you’ll want to make a copy of their photo ID and their insurance card and collect any applicable co-pay.