The Window to Coverage and Benefits

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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Commercial Health Insurance Verification Mastery

This tutorial provides tips and tricks for the clinic to master the verification process. The staff member will learn how to use the verification template for gathering information that can assist with reimbursement. We even provide a peek at the many resources a clinic can find online via payer portals that help the clinic avoid...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

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...
OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.