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Insurance Verification Form
What Is a Verification of Insurance Form?
An Insurance Verification Form is a document that a medical institution will use to check the medical coverage of an individual patient. A staff member from the health center will send this form to the insurance company where the patient is insured. An Insurance Verification Form template can be downloaded through the link.
Alternate Name:
- Medical Insurance Verification Form.
The insurance company will then fill in this form and provide both medical and personal information relating to the patient. After this, the insurance company will send the form back to the medical institution where a team of healthcare professionals will be able to make decisions on the appropriate treatment based on the insurance coverage.
How to Fill Out an Insurance Verification Form?
Filling out an Insurance Verification Form may look more daunting than it actually is. Of course, these may differ ever so slightly depending on the medical facility, but usually, they all follow this similar structure:
- Information regarding the patient. In this part of the form information such as the full name, full address, contact telephone numbers, Social Security Number, gender, date of birth of the patient are all written down. Here you can also write down any codes relating to diagnosis (using International Classification of Diseases codes).
- Information regarding the insurance company or companies in cases where there is also a secondary insurance company. In this section details about the name of the insurance company, policy number, and insurance company contacts should be provided. If there are other insurance companies insuring the patient, their details should also be provided.
- Information regarding insurance coverage. Here you are required to provide information about the policy coverage; particularly information about the date the policy came into effect, whether or not the policy is still active, the coverage plan type, any benefits the patient is entitled to during treatment, information regarding deductible sums and other financial obligations.
- Information about the insurer. Here the personal details and contact details of the insurance representative should be noted down including the date and time of the call, their name and contact numbers should the medical institution need to get in touch to clarify any information. Any other relevant information about the insurer should also be included in this section.
In case of dental problems, a dental office can use a Dental Insurance Verification Form to enquire about dental coverage from the insurance company. The process is identical to medical insurance verification, it requires the insurance company to fill out the information about the patient and what dental care is covered by the insurance.
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