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Eligibility and insurance verification is pivotal to ensuring accurate and timely receipt of information regarding insurance coverage, and determining the patient’s responsibility to pay for healthcare services. Many healthcare providers do not pay the needed attention to eligibility and verification process. Accurate and timely determination of the patient’s eligibility provides healthcare providers a clear view on patient’s coverage, out-of-network benefits and accurate insurance information. Incorrect insurance information could result in delayed payment at best, or denial at worst.
This webinar will discuss the basics of insurance coverage, eligibility, and prior authorization to assist providers in obtaining this information from insurance companies to help patients understand what their insurance will pay, and what may be their responsibility.
Most insurance companies offer different plans that cover different services and procedures. Once an office has verified that a patient is eligible for benefits on a particular day, the coverage will determine what the insurance company will pay, and what may be the responsibility of the patient.
- Learn the differences between a patient’s insurance coverage, eligibility, and prior authorization to be able to apply their knowledge in your practice
- Understand different types of coverage plans
- Identify which services require pre-authorization
- Understand ins and outs of contacting the insurance company of prior-authorization and what to do in the circumstances when the procedures performed change during the surgery
Areas Covered in the Session:
- Coverage plans and the difference between plans
- Ways to obtain eligibility and when should it be done
- Determine what services or procedures need prior-authorization before they are performed
- What to do if procedures change and prior authorization is no longer correct
- Meeting medical necessity even when prior authorization has been obtained
Who Should Attend:
- Facility Inpatient and Outpatient Coder
- Medical Assistants
- Claims Processors
- Payment Posters
- Anyone involved with Professional fee for service billing and coding
About the Presenter:
Lynn M. Anderanin, CPC, CPMA, CPPM, CPC-I, COSC, is the Sr. Director of Coding Education for Healthcare Information Services, a physicians revenue cycle management company. She has over 35 years experience in all areas of the physician practice, and specializes in Orthopaedics. Lynn is currently a workshop and audio presenter. She is a former member of the American Academy of Professional Coders (AAPC) National Advisory Board and has served on several other boards for the AAPC. She is also the founder of her local chapter of the AAPC.
You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
Can’t Listen Live?
No problem. You can get access to On-Demand webinar. Use it as a training tool at your convenience.
For more information you can reach out to below contact:
Toll-Free No: 1-302-444-0162