Patient Registration Case Study

To verify Sylvia Baker’s insurance Lewis should politely ask Sylvia for her to fill out the new patient registration forms. Once the paperwork is filled out completely, he should ask for her insurance card or cards, and ask for her driver’s license. Lewis should make sure that both birth dates are the same on the driver’s license and on the new patient registration forms. Once that is verified Lewis needs to look on the patient registration forms to see the relationship between Sylvia and the insured. He then needs to look at the insurance card to locate the name of the policy holder, the member ID, and the telephone number of the insurance company. Lewis needs to call the provider customer service line of the insurance company which is provided …show more content…
He will need to verify the name and birthdate of the policy holder as well as verifying the name and birthdate of the patient. When speaking with the customer service representative he will need to verify the type of service that will be taking place along with the number of visits and whether a prior authorization will be needed. Patient’s financial responsibility for copayments, coinsurance and deductibles will also need to be known as well as the insurance address needed for mailing claims or the payer number for electronic billing. One reason that Mr. Flannery’s claim was rejected could be because of being electronically submitted. When being submitted electronically the transmission of the claim could have been disrupted by a power failure, computer hardware or computer software problems. The claim then would have to be resubmitted and even though a bill was sent to the patient the claim may get paid the next time around by the insurance company and the patient would not owe anything. Another reason that the claim could have been rejected could be that some patient billing programs are unable to create electronic attachments. When an electronic attachment is