Insurance calling process - Script for paid claims

Insurance calling - step by step for paid claims


If A/R caller receive this answer, then the following details needs to be obtained from the insurance representative,

1. What is the amount paid towards the claim?
2. What is the check#?
3. What is the check date?
4. What is the total amount of the check?
5. Which address they mailed the check?
6. Check whether the payment was mailed to the correct address or not.
7. If the check date is more than a month, then get the date on which the check was cashed.
8. Close the call. *


Calling Script



DAVID is the name of the person in our billing office and he is calling the insurance company BC/BS of MD for checking on claim status.

DAVID : Dialed insurance company telephone #.

Insurance Rep : Picks the phone “ Thanks for calling, this is SANDY, how may I help you today”

DAVID: “My name is DAVID, I am calling from Doctor office and I would like to check claim status for a patient”

SANDY : “Which doctors office you calling for?”

DAVID : “I am calling from General Oncology Associates”

SANDY : “What is your telephone #?”

DAVID : “My telephone # is 1-800-999-9999”

SANDY : “What is the patient’s Social Security Number?”

DAVID : “The social security number is - - - - - - - -“

SANDY : “Can you hold for a moment, I will pull up this patient record”

DAVID : “Yes, Please”

SANDY : “who is the patient?”

DAVID : “patient name is Linda Far”

SANDY : “what is the date of service?

DAVID : “01/26/2008”

SANDY : “what is the billed amount on the claim? DAVID”

DAVID : “Yes, SANDY, the billed amount on the claim is $1500.00”

SANDY: “Can you hold for a moment, I will search for that claim”

DAVID : “Yes, SANDY”

SANDY : “Thank you so much for holding, this claim was paid”

DAVID : “What is the amount paid towards this claim?”

SANDY : “$528.26”

DAVID : “What is the check #?”

SANDY : “Check # is -------“

DAVID : “What is the check date?”

SANDY : “Check date was 03/10/2008”

DAVID : “What is the total amount on the check?”

SANDY : “$1125.26”

DAVID : “Can you provide me the address where this check was mailed”

SANDY : “This check was mailed to --------------“

DAVID : “Is this check was cashed?”

SANDY : “Yes, this check was cashed on 03/30/2008”

DAVID : “Thank you so much for your information and have a nice day…”


Insurance verification process


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