Verifying Insurance - in progress

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Why you do not let patients do this for you.

Publish Post

Workspace and set-up

Private. Phone. Prepare to be on hold. Tues through Thu, 9 am to 3 pm.

Computer access is becoming more and more helpful. although carriers' websites are still not likely to answer the questions you must ask when verifying chiropractic care.

Make a verification form so that every thing you need to know gets verified. You may keep it internal or share it with your patient as you see fit.

The disclaimer.

Identifiers: Yours: Tax ID, NPI, phone number, address, or online log and password
Have these to hand in the work space.

Identifiers: Patients: Name, ID number, claim number, birth date, Group,
copy the insurance card, front and back. Copy photo id with birth date. Driver's license is ideal.

Key questions:

Jane would like to know if your plan covers chiropractic care at our office.

Does Jane need to file any documents to apply for benefits?
Typically, Auto accident victims must provide an application fro PIP benefits, a recorded interview with a claims examiner, or both. Injured workers must file the claim as well, either newly (in a WC 827 form) or as a transfer patient who was seen elsewhere.

Is this plan connected to a preferred provider group?
~~If so, is our doctor in the group?
When in doubt, get both benefits.

Do you require a pre-authorization or referral for benefits?
~~If so, who should I contact to get one?

Is coverage current and available now?
~~if a denied or exhausted injury claim, is there an attorney on record?

Benefits summary

This is the part you CAN find online... and the claims agent is well-trained in answering:
Warning... the answers can be complex and contradictory.

~What are the benefits, co-payments, and deductibles?
~When do benefits exhaust? How much as been used?
~Are there daily or yearly limits to care?
~Are there any exclusions to scope-of-license care,
~~~such as therapy, orthotic equipment or massage?
~To what address should claims be sent? E-billing number?

Ending wrap up.

Is there another insurance that may cover this patient according to your records?

Your name and a reference number for this call?

Sample form: