Managed care insurance product be required

Reference no: EM133617348

Patient Eligibility and Preauthorization

For this assignment, you are to answer each of the following questions in a short essay format.

Please note that you may have to perform outside research for this task.

1. Describe when a patient referral for a specialist who has a managed care insurance product be required?

2. You are on the job and are required to verify insurance eligibility for your new patients in tomorrow's schedule. What steps would you complete to go about this process? What if there is a patient on the schedule who is not eligible for insurance benefits for the insurance the medical practice has on file? How would you handle this?

3. Describe the process used for obtaining documentation once each new patient in the above scenario has been verified.

4. What is pre-authorization and why is it important? Are pre-authorization and pre-certification the same? Explain your rationale.

Reference no: EM133617348

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