Verifying BCBS Review the resource Managing the Blue Card Plans located in the Commercial Health Insurance module to identify the different types of Blue Plans. Once you have identified the alpha prefix, simply call BlueCard Eligibility to verify the patient’s eligibility and coverage at 800-676-BLUE. BCBS states “Operators are available to assist you weekdays during…
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Download Support Tool This tool provides a sample of a completed verification form. Follow along with the sample template as you view the Rapid Tutorial on Proper Use of the Verification Form. Take note of areas that are missing in the clinic’s current verification process and look for ways to improve on gathering this information….
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Download Support Tool When building a verification process, it is necessary to learn about the different payers. A staff member can do that each time they call and verify, or they can create an insurance binder that documents the contract requirements and restrictions. Each payer outlines their preauthorization and precertification requirements. If it includes chiropractic…
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Medical Review Policies Once you have located all the payer documents that are related to the services you provide in your clinic, do not stop there. We recommend that you create a folder on your computer for each payer and save the documents in a dedicated folder. It might be best to date the folder…
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Coverage and Benefits For a clinic to run efficiently, the staff must be familiar with the terms Summary Plan Documents (SPD); Summary of Benefits and Coverage (SBC); Payer Medical Review Policy (MRP); Payer Reimbursement Policy; Policy Guidelines; Payer Clinical Guidelines, and the Provider Manual. The mini-class titled MRP-What Does It Mean to Me? provides a…
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If you bill insurance, the Medical Review Policy (MRP) is one of the most important documents for successful billing and reimbursement. In this quick tutorial you will have the opportunity to view the process of viewing and downloading these documents online.
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