Author Topic: Verifying Benefits  (Read 1497 times)

ste

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Verifying Benefits
« on: May 17, 2012, 01:55:52 AM »
While verifying benefits I noticed there was not a phone number or website anywhere on the insurance card. United Healthcare and Pacificare were printed on the front. UHC wouldn't route the call to a rep because of the unrecognized member ID and googling Pacificare for a phone number only led back to UHC. I reported back to the office suggesting the patient contact his employer for an insurance phone number.
What would have been the best way the handle this situation?

PMRNC

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Re: Verifying Benefits
« Reply #1 on: May 17, 2012, 06:11:17 AM »
Sounds like it could be a phony ID card, it happens.  In this case if the patient has not been seen, a phone call can be made to explain that benefits could not be verified and see if they give you anything else. If they give you more information that is not checking out, I'd probably call back the carrier and request to speak with someone in provider relations to find out where to go from there. They may advise you to send them a copy of the ID Card. 
Linda Walker
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Satish

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Re: Verifying Benefits
« Reply #2 on: June 01, 2012, 09:55:09 PM »
While verifying benefits I noticed there was not a phone number or website anywhere on the insurance card. United Healthcare and Pacificare were printed on the front. UHC wouldn't route the call to a rep because of the unrecognized member ID and googling Pacificare for a phone number only led back to UHC. I reported back to the office suggesting the patient contact his employer for an insurance phone number.
What would have been the best way the handle this situation?



Hi,

You can go in two ways, you can try to pull out the information by providing the SS# or else can contact the patient for the correct ID#

Satish
« Last Edit: June 02, 2012, 05:10:30 AM by Satish »

Sriram_Sub

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Re: Verifying Benefits
« Reply #3 on: June 04, 2012, 07:30:27 AM »
Hi Ste,

I was able to find something for you. But not sure if it would help for your current situation. However, this will help you in the long run. Please click on the below links and see if you are able to check eligibility online. I could only access to some extent of the website as it requires me to register as a provider. Again, I am not sure about what information would be asked by the site to check benefits. Please check if this would help. Once you register, your Login and password will be mailed out in 5 to 7 days with which you may verify benefits.

Click on the below URL to register your provider:

https://www.uhcwest.com/commonPortal/application?origin=hnav_bar.jsp&event=bea.portal.framework.internal.portlet.event&pageid=ProviderRegistration&portletid=ProviderRegistration&wfevent=link.providerRegistration&navnode=Register.1


Once you get your Login & Password, click on the below URL and click on "Services and Tools" from the Quick links on the left, which will take you to various online services offered by the Carrier:

https://www.uhcwest.com/commonPortal/ProviderLink?navnode=DoingBusiness.2.2#q1

Sriram