When a claim is outstanding and there is no response from the insurance company, we need to call the insurance company to check the status of the payment or denial. When doing follow up, the insurance company will ask for your name, number, tax id, provider names, pt name, policy #, date of service, date of birth, charge amount and sometimes providers address.
Example we’ll use
Tax id 52-1234567
Provider Dr. John Jones
Provider Address Po Box 1234, anywhere city, state, zip
Policy number 256RL6523
Pt name, Jill Jackson
DOB 11-01-1955
DOS 1-12-2006
Charged amount $300
Example call:
ABC Insurance Co: ABC Insurance Co Lisa speaking can I get your provider #
You: 52-1234567
ABC Insurance Co: Who am I speaking with?
You: Amy
ABC Insurance Co: Is there a call back number for you.
You: 410-555-1212(this is your office number)
ABC Insurance Co: What is the name of your provider?
You: Dr John Jones
ABC Insurance Co: Patients name and DOB
You: Jill Jackson 11-1-55
ABC Insurance Co: And the Patients policy number?
You: 256RL6523
ABC Insurance Co: DOS and charged amount
You: 1-12-06 $300
ABC Insurance Co: Thanks, how can I help you?
You: I need to know the status of payment
ABC Insurance Co: Ok I’ll check the status for you.
You: Thanks
The insurance company will either tell you when the claim was paid or tell you if it was denied.
Thursday
Insurance Follow Up
Posted by Ginene at 4:41 PM
Labels: Follow Up, Medical Billing