General Category > General Questions
Insurance Verification Errors
Pay_My_Claims:
--- Quote from: PMRNC on May 07, 2009, 04:24:32 PM ---ABSOLUTELY.. it's step one to getting paid.. the person doing this job NEEDS to be well-versed in what's at stake. When I get a client that wants full practice management I include this service because I know it's vital to reimbursement. I prepare the staff with a "pre-screening" form with data they are to collect when they make the appointment and by the time the patient comes in, benefits are verified and the front office knows what to collect at the front desk.
Linda Walker
PMRNC
www.billerswebsite.com
--- End quote ---
Yes, and there is no one form that can do it all. I designed verification forms according to the specialty. Different questions apply to different scenarios!
Michele:
I'm curious, if the girl wasn't told that they PT, massage, etc would be covered, would they have still been billed? Also, when the eob came back, did it show them as Patient Responsiblity?
I agree with the other responses posted so I won't bother to reiterate.
Michele
Amit_Nischal:
The only thing you can try to appeal the denial asking them to reconsider based on the benefits quoted. Also, it would be great, if you have insurance representives name . Simultaneously, you might want to look into whether you can bill the patient, especially without having notified them first that services wouldn't be covered and see if an ABN is necessary/signed by the patient or not.
Thanks,
Amikt
PMRNC:
Insurance carriers always state that verification of benefits is NOT a promise of payment. It's also in each policy holders book and in every provider contract.
Pay_My_Claims:
I had something similar happen, but it was on an inpatient basis. I documented everything, but then they tried to of course back up the employee. I told them I would have the client call regarding the matter....things changed shortly after that!!
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