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Answer 1-lp The scenario: You are in private practice in your own office. You are newly starting out and have no staff yet. You are
Answer 1-lp The scenario: You are in private practice in your own office. You are newly starting out and have no staff yet. You are a provider with a number of third party payers. The phone rings and you answer it. The person on the phone is John Doe. He explains he was told to call you by his doctor and make an appointment. He was recently diagnosed with type 2 diabetes. His doctor wants him to lose weight. 1. What questions do you have or information do you need to obtain from Mr. Doe concerning his insurance while he is on the phone? Mr. Doe says he has Blue Cross Blue Shield (BCBS) through his work and has the written referral from his doctor. Now that you know Mr. Doe's insurance carrier and he says he has a referral, what addit onal information do you need about Mr. Doe's insurance and referral? 2. You call Mr. Doe's BCBS. 3. 4. What information do you need to have to speak or check online with his insurance? What questions do you need to ask Mr. Doe's insurance company in order to determine if your MNT will be covered for Mr. Doe? Mr. Doe was approved by BCBS for 24 units of MNT for 180 days starting on December 15, 2013. The first appointment is made for Mr. Doe for January 2, 2014 at 1:00 p.m. It is January 2nd at 1:00 p.m.Mr. Doe has arrived to your office for his MNT. 5. What must you obtain from him at the appointmenti? After the appointment you will need to submit an insurance claim form for Mr. Doe's service. 6. What is the name of the insurance form to complete in private practice
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