Can SAVE expect to be paid for services rendered for insurance patients?
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Do you have verification that insurance is ACTIVE?
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NO
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Get the correct insurance from the patient or referring physician office.
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NO
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Patient is SELF PAY & payment is expected at Time of Service.
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YES
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YES
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Are we IN Network (checked on our spreadsheet or confirmed by phone?)
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NO
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STOP-Verify by phone or using our spreadsheet that we are NOT in network.
NOT in network?
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NO
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Check to see if patient has OUT OF NETWORK benefits.
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NO
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We can not see this patient at SAVE under their insurance plan!
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YES
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YES
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YES
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Is this an HMO?
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NO
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Is this a PPO?
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Determine the patient's financial responsibility and discuss with them the add'l costs since we are NON-PAR
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YES
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YES
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Do you have a referral in writing from the PCP?
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NO
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STOP-Check to see if referral is required.
Freedom or Optimum? MUST have written referral!!!
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YES
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Do NOT allow patient to be seen until you have the PCP's referral.
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YES
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Insert this info in the referral section of Greenway.
Do you know the co-pay due?
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NO
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Review the patient's card, verification info, or call to determine amount.
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YES
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YES
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Create a flag on the account & document the co-pay due.
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Insurance Checklist
