HCRWK3(Checkpoint) - the staff member should let the...

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Eligibility, Payment, and Billing Procedures By: Tosha Padgett HCR/220 Instructor Jessica Ellis University of Phoenix Due: January 12, 2012 If a patient has an employer-sponsored health care plan, many factors can determine his/her benefit eligibility. For example, employment status can change daily, which in turn means the patients eligibility can change as well. The patients coverage can end when the month ends because the employees “active full-time service” can end then. Also, some companies allow benefits for full-time employees only. So, if the employee switches to part-time for some reason they may not qualify for the benefit coverage anymore. Some policies have an age limit and, due to this, every month the coverage for many patients can change. In the situation that a patient is not covered for a specific planned service,
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Unformatted text preview: the staff member should let the patient know that their payer is not covering that particular service. The patient should also be told that they are then required to pay for the service if it is rendered. Some payers have forms available for their physicians to give to the patient. These forms are “financial agreement” forms, which let the patients clearly see what services are and are not covered in their policies. The patient is required to sign the form, which then proves that the patient has been informed that they are responsible for paying the bill before the services are rendered. I am not really understanding exactly what you are asking for in the third step of the checkpoint. I wish I did and I should have asked before it was due. Sorry....
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HCRWK3(Checkpoint) - the staff member should let the...

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