Verification of Insurance

Staff Training University Module:

VERIFICATION OF INSURANCE

Pulling up the information you need first in the system:

GO TO FACILITY SCREEN

click on 1720 W. Belmont

Now you will have all the information you need to answer all questions on the office

Will ask NPI # 1912941105

Tax ID# 061768782 (usually they just ask for NPI #)

Chiropractical Solutions or your Name

847-477-9988 contact #

GO TO PATIENT INFORMATION (you can have both screens open for all information)

Pull up patients chart on computer

If you click on the Insurance portion for that patient you will see

Patient name

ID#

Date of birth

(Once you get all information from questions below then you ENTER IN ALL INFORMATION FOR PATIENT under ADD NOTE for that individual patients chart)

NOW DIAL the Insurance company #:

*ASK THE FOLLOWING QUESTIONS:

There may be an automated system first

If Automated System then the answers are as follows

What type of office? Medical office

What is the specialty? Chiropractic

Where are the services performed? Outpatient office

ID#? Enter patient ID

What info are you looking for? Benefits and coverage

Listen to the information and get detailed explanation of benefits

Always wait to hear the prompts and get a representative on the line at the end so you can have them go over all details

Questions to ask Rep:

Write down NAME OF REP and Time and Date talked to

1. I am looking for CHIROPRACTIC and Physical Therapy BENEFITS?

They will start telling you all benefits and make sure they include all below and if not then ask them

3.. HOW MUCH is DEDUCTIBLE?

4. How much of the DEDUCTIBLE AMOUNT has BEEN MET?

5. What are the MAX BENEFITS for Chiropractic and Physical Therapy? Has anything been met towards those benefits?

This will either be a dollar amount or a maximum # of visits the person is allowed per year

6. What is the coverage for Office vists/initial Examination? Is this subject to the deductible or is it just a copay amount?

7. What is the coverage for ORTHOTICS?

What address to send the claim to?

WRITE ALL INFO DOWN on ADD NOTE FOR THAT PATIENT. INCLUDING REPRESENTATIVE and CONFIRMATION # / NAME/ DATE AND TIME.

RESTATE & CONFIRM ALL INFO FOR SECOND TIME WITH CUSTOMER SERVICE REP.

TYPE ALL INFO INTO PATIENT ELECTRONIC FILE.

EXAMPLE:

NAME of rep: Tom Brook DATE: July 18, 2009 TIME: 9:20am

Deductible $250 ($250 met) All met

Office visit

paid at 100% with a $20 copay

Chiropractic

90% after deductible met

$1000 Max

0 used

Physical Therapy

90% after deductible met

$5000 Max

0 used

Orthotics

$20 copay and need letter of medical necessity