Checkpoint: Eligibility, Payment and Billing Procedures

CheckPoint: Eligibility, Payment and Billing Procedures Vanessa Merassaint HCR/220 November 1, 2012 Pamela Kerby thither argon several(prenominal) assorted chemical elements that determine a patients benefits eligibility. The gene I would like to bring caution to is; if premiums are strike the patient must have paid on prison house term and that they are up to date. The appropriate steps to push when damages policy does non cover a planned return is plow the situation with the patient, making sure that they understand that they are non covered by the insurance and will have to conduct out of pocket for the services that are needed. In unidirectional terms if the patients benefits have lapsed and or no payment has been made, when and if the patient needs medical concern they will have to pay out of pocket for those services. on that point could be several factors to why the patient has either no benefits or the procedure that needs to be d one(prenomina l) is non covered. Could be the payment was late, or was told the insurance was paid when in reality it was non; this happened to my brother, in the end he fought and won it was the insurance companies error.

When selecting an insurance plan maybe the information was not clearly stated or simple just thought process that it couldnt happen to you. Two examples of patient charges that would have to be out of pocket are cosmetic surgery and yearly somatic trial runs. I understand why insurance companies would not cover cosmetic surgery, even with the simplest procedure anything could happen, its a liability issue . Not covering an annual physical examinatio! n is something that I do not understand; the insurance companies I have dealt with an annual physical is covered. I derive that is one for the books.If you want to get a full essay, position it on our website: OrderCustomPaper.com

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