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Explore This IssueJanuary 2012
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- B. Although the other choices are good, without getting a patient’s insurance information, there will be no reimbursement. Verification of insurance eligibility prior to the visit will avoid nonpayment.
- C. It does not matter how long a patient has been seeing the physician. When a patient is beginning a new procedure, calling the insurance company to find out benefits and prior authorization requirement is necessary to avoid delay in reimbursement for the service.
- False. It is strongly recommended that insurance eligibility be verified before all costly treatments. A patient’s insurance coverage can change visit to visit, and if you do not verify eligibility with the insurance carrier at every visit, you risk not receiving reimbursement from the new carrier or the patient.
- Yes. See number three above for explanation.
- Trick question. This should be a practice decision. ACR-certified auditors recommend eligibility be verified for every patient at each visit, but many small practices cannot handle the additional workload. In this case, eligibility should be verified, at minimum, on all expensive treatments, such as infusions and high-end radiological procedures.