1) Start with accurate demographic information
a. Patient's Information (Name, Address, Home/Cell Phone, Marital Status,
Employer)
b. Primary Insurance Information (including the policy holder/guarantor's
information)
c. Patient Relation to the Policy Holder (Self, Spouse, Child, etc)
d. Social Security Number
e. Secondary Insurance Information (if available)
f. Referrring Physician or Person
g. Adjustor, Nurse Case Manager and Attorney's Information (if available, this is
very important/useful for Auto and WC Claims!)
2. Check for their Medical Benefits and Eligibility (this is a MUST!)
3. Copy their Insurance Card(s) - front and back!
4. For Auto and Workers Comp Claims - check if the claim is open based on
your specialty (Orthopedic, Pain Management , etc), verify which body part the
patient is being treated for, and also very important - know the date of
accident/incident! (also a MUST!).
5. Obtain Prior Authorization/Pre Certification if required! (this a MUST!)
There you go. I hope this helps. The above tips are just my recommendation. It
may not be applicable to your practice but may be useful to other practice.
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