To truly understand how commercial insurance works, you need to locate the guidebook. This is often referred to as the Medical Review Policy (MRP) or Reimbursement Guidelines or Clinical Guidelines. The MRP is often made available to clinics through a provider portal or on the insurance carrier’s website. Simply conduct an internet search for that…
Insurance Coverage Detail Documents
Collecting Other Detail Coverage Documents In addition to Insurance Verification, it is advisable to collect both the Summary of Benefits and Coverage (SBC) and the Summary Plan Description (SPD) for each patient and store these documents where they are easily accessible. This is just another good practice will that help both you and your patients…
Verifying Insurance is the Best Practice
Don’t Forget to Verify Insurance Insurance Verification is a simple step that provides a clear picture of who is responsible for what portion of patients’ charges. Collect the patients’ insurance information from the first phone call so that by their first visit, insurance coverage is understood, and patient responsibility can be calculated based on the…
Why Insurance Verification
Why Insurance Verification This quick tutorial explains why insurance verification is an important piece of the financial report of findings (FROF) with the patient. It contains the top tips to make the verification process simple and effective by reviewing the variety of tools available in the KMC University Library. This image provides a sampling of…