Verifying BCBS

purpose to verify a patient’s active bcbs coverage , review deductible, out of pocket, coinsurance, copay, and visit limits , and communicate the patient’s estimated responsibility for chiropractic services when use this process when a patient has bcbs insurance and the office needs to confirm benefits before scheduling, checking in, or discussing payment options who this process should be completed by the front desk, insurance verification coordinator, or designated team member responsible for eligibility and benefit checks procedure 1\ log in to the bcbs portal log into the bcbs insurance portal using office credentials 2\ go to health eligibility once logged in, go to health eligibility 3\ enter patient information type in the following member id first name last name date of birth then click search note certain members may come up automatically if their bcbs plan is from north carolina 4\ review coverage details once the patient record opens, acknowledge and review deductible amount out of pocket amount co insurance important note once the out of pocket maximum is met, the patient is covered at 100% 5\ review rehab/therapy services scroll to rehab/therapy services and click into chiropractic 6\ confirm copay, coinsurance, and visit limit under chiropractic , review copay coinsurance visit limit bcbs deductible patient fee guidelines 7\ use office fee guidelines for deductible patients for bcbs deductible patients , use the following fee amounts (without x rays) new patient / re exam visit $83 85 regular office visit $67 85 20% co insurance $16 67 8\ self pay election requirement if the patient chooses to do self pay instead of using insurance, they must sign the enf (election not to file) purpose documents that the patient is choosing not to have the office file insurance for services documentation after verifying benefits, document the following in the patient chart or benefit notes insurance verified deductible amount out of pocket amount coinsurance or copay visit limit whether patient is using insurance or self pay whether enf is needed or signed, if applicable purpose keeps a clear record for scheduling, billing, and patient communication quick reference go to health eligibility enter member id, first name, last name, and date of birth review deductible, out of pocket, and coinsurance go to rehab/therapy services > chiropractic confirm copay/coinsurance and visit limit for self pay , patient must sign enf standard patient estimates for bcbs deductible patients new patient/re exam $83 85 without x rays regular office visit $67 85 20% co insurance $16 67