Insurance calling process

How to call insurance


The Night caller or AR caller (India) will call the insurance companies based on the patient accounts given by the Analyst (If it is in India, In US both persons are same). Caller will documents the telecom conversion in those respective patient accounts; also caller will send a report to the A/R Analyst on daily basis.

A/R caller will calls insurance companies over the telephone in order to get the reimbursement in a timely fashion. Let us see how the A/R caller calls the insurance companies.

PRE-CALL ANALYSIS

1. Check the Insurance Company name & phone #.
2. Check the Patient id #, name, and SSN & group #.
3. Check the Date of service & billed amount and see whether the claims fall beyond the benchmark.


DURING THE CALL

Usually A/R caller introduces himself or herself to the insurance company representative by giving their American Name & the Doctor’s office name, and then say “I want to check claim status”.Then A/R caller gives the Patient id #, name, date of service and the billed amount.


Claim Status

There are six possible answers will be received from the insurance side, they are

a. Claim Under Process
b. Claim Denied
c. Claim Paid
d. Claim pending or suspended
e. Claim Approved for Payment
f. Claim Not on File

We will see each possibility in detail.

No comments:

Medical Billing Popular Articles