Answer Happy

Reivew Page 371, Kinn's Procedure 18.1, in the textbook. Submit a paragraph in Microsoft Word identifying the following information: 1. What is the name of the insurance plan? 2. What is the insured's name? 3. Group # 4. ID # 5. Dependents 6. Effective Date 7. Copay(s) 8. Address of insurance 9. Phone number of insurance company Add a four sentences summarizing why it is important to be able to identify the information listed below. List at least one other function in the medical office this impacts.
PROCEDURE 18.1 Interpret Information on an Insurance Card Task: To identity essential information on the health insurance identification (ID) card, so as to confirm copayment obligations ond obtain accurate health insurance information for cloits submission EQUIPMENT and SUPPLIES • Patient's health insurance ID card, both sides (see the following figure) Front AETNA INSURED: Tapia, Amold IDENTIFICATION : CH1197845 DEPENDENTS: Tapia, Celia B GROUP #: 33347H EFFECTIVE DATE: 08/26/2012 PROCEDURAL STEPS 1. Review the patient's health insurance ID card and identify the insured on the health insurance ID card. If the patient is someone other than the insured, obtain the relationship with the insured and the insured's date of birth and gender. PURPOSE: To submit an occurate health insurance claim, the insured's done of birth and gender are required. 2. Identify the insurance plan PURPOSE: To confirm that the provider is a participating provider for the insurance plan or the HMO network. If the provider is out of network, the patient should be informed that he or she will either have to pay more out of pocket or the medical services rendered will not be covered by the insurance plan. 3. Identify the insured's identification number and group number. PURPOSE: To accurately submit the health insurance daim under the corect insurance policy number and group number. 4. Identify the patient's copayment, which is due before the appointment Collect the correct amount. (For example, if the provider is a specialist, collect the copayment listed for specialist.) PURPOSE: To ensure that the proper copayment is paid by the patient. 5. On the back of the health insurance ID card, make sure that a customer service phone number and medical claims address are present. PURPOSE: To ensure that the provider can contact customer service and has the correct moiling address. CO-PAY: $25 SPECIALIST CO-PAY: $35 EMERGENCY DEPT: $35 DRUG CO-PAY GENERIC: $10 NAME BRAND $50 Back Submit claims to Aetna 1234 Insurance Way Anytown, AK 12345 Member Services: 1-800-123-222 Insured. It a fe threatening emergency exists, seek immediate attention