Correctly Identify Insurance

At the hospital/office, we’re only as up to date and informed as the information given to us. If we’re not given any information, however, then it stands to reason that we’re not informed or up to date. If we’re not given any information because we can’t squeeze blood from a rock, that’s one thing. If we’re not given any information because we aren’t asking for it, then shame on us.

It is vitally important that we are viewing insurance cards when we do account updates. It’s important that we ask the patient to get their insurance card and read us the numbers when updating an account over the phone. My favorite errors are where the account comments read “no insurance changes per pt” or “per mom”. And then guess what? The patient’s Medicare ID isn’t their SSN with an A after it. They now have a Medicare Advantage Plan instead of classic Medicare. Or, their business changed from Aetna PPO to Aetna HMO, but we only asked if they still had Aetna.

It’s concerning when the account information states that the patient was just completely updated, yet the Anthem website says we have the wrong insurance prefix or the wrong review group, address, subscriber, etc.

If we are sure to stress that we need to see the card instead of asking “have there been any changes,” then we are less likely to have incorrect billing information. When you have correct billing information, you are saving your business money. When you have correct billing information, you are performing very good service to your patients because they don’t receive bills for services that should have been paid for by their insurance. When you collect correct billing information, we all win.

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