HCR 220 Week 3 Checkpoint Eligibility, Payment, and Billing procedures

HCR 220 Week 3 Checkpoint Eligibility, Payment, and Billing procedures

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Checkpoint: Eligibility, Payment, and Billing procedures 1 Checkpoint: Eligibility, Payment, and Billing procedures Josh Gorban HCR 220
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Checkpoint: Eligibility, Payment, and Billing procedures 2 When determining if a patient is eligible for benefits, there are three main factors that must be considered. The first factor is determining if an eligible dependent’s coverage will cease on the last day of the month in which the dependant status changes. One reason for this could be that the dependant has reached the age limit which is stated in the policy. The next factor is determining if the coverage will cease on the last day of the month in which the employee’s active full-time service ends. Circumstances pertaining to this factor could be that the employee was on disability, had been laid off, or terminated. The last factor is determining if the employee no longer meets the criteria of a member of the group. Some companies do not provide benefits
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HCR 220 Week 3 Checkpoint Eligibility, Payment, and Billing procedures

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