Verifying Insurance
1 min
You will need: Front/Back of patient's insurance card Date of Birth/Photo ID
- Call the provider # on the back of the patients' card **If there isn't a provider #, call the customer service # and wait for provider option
- Choose ELIGIBILTY/BENEFITS on the prompts
- Be prepared to type in or say patients ID
- When it asks to fax or tell you the benefits - press 0 or say CUSTOMER SERVICE and they will take you to a live person (most of them do, if you cannot get to a person without listening to the machine first-just hold and try to press 0 after the machine is done)
Verifying the benefits:
- GET THE PERSONS NAME YOU ARE SPEAKING TO!
- They will ask you to verify practice information-please be ready
- Tell them you need CHIRO & PHYSICAL THERAPY BENEFITS
- Tell them they will be performed IN OFFICE by a CHIROPRACTOR
- Ask them if this is a calendar or anniversary year policy?
- Calendar = 1.1.24 - 12.31.24
- Anniversary = 5.31.24 - 4.30.25
- Is a REFERRAL required? (most of the time the answer is NO-this is also known as a Precertification)
- We always need IN NETWORK benefits
- If they have a deductible ask-DOES CHIRO & PT APPLY TO THEIR DEDUCTIBLE?
- MAKE SURE TO GET DEDUCTIBLE AND OUT OF POCKET AMOUNT AND HOW MUCH HAS BEEN MET?
- If their deductible applies-what percentage are they responsible for after it is met? 10%, 20%
- WHAT IS THEIR VISIT LIMIT? (Sometimes it's a dollar amount i.e. $1000)
- REPEAT EVERYTHING BACK TO THE CUSTOMER SERVICE REP
- MAKE SURE TO ALWAYS GET A REFERENCE #