CheckPoint: Eligibility, Payment and Billing Procedures Vanessa Merassaint HCR/220 November 1, 2012 Pamela Kerby thither be several(prenominal) diametric chemical elements that determine a patients benefits eligibility. The actor I would like to bring caution to is; if premiums are subscribe the patient must have paid on prison house term and that they are up to date. The appropriate steps to concentrate when restitution policy does non cover a planned assistance is plow the situation with the patient, making sure that they understand that they are non covered by the indemnity and will have to postulate 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 assistance they will have to pay out of pocket for those services. at that place could be several factors to why the patient has either no benefits or the procedure that needs to be d unmatched is non covered. Could be the payment was late, or was told the insurance was paid when in reality it was not; this happened to my brother, in the end he fought and win it was the insurance companies error.
When selecting an insurance plan maybe the information was not clearly stated or simple just thought that it couldnt happen to you. Two examples of patient charges that would have to be out of pocket are cosmetic surgery and annual strong-arm trial runs. I understand why insurance companies would not cover cosmetic surgery, even with the simplest procedure anything could happen, its a lia bility issue. Not covering an annual physica! l examination is something that I do not understand; the insurance companies I have dealt with an annual physical is covered. I theorise that is one for the books.If you want to get a full essay, evidence it on our website:
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