First things first: Does the patient have an active insurance?
The situation is where you start. You learn by dealing with real-life work situations. Provide a short description of the situation for the learners to work on. Along the way, you will impact results.
Sitches are situations, jams, issues, errors, gaps, troubles, stoppages and many others to fix and solve. They are also opportunities to improve, grow, expand, and introduce better, faster and cheaper ways to get the desired results.
What is your Situation and Question?
It was such a busy day in the doctors' clinic. During a quick break, Dr. Mandy Charleston decided to approach Alice, one of the new hired front desk staff, to verify an issue:
Dr. Charleston: Hello, Alice. How are you?
Alice: I'm good, Dr. Alice. How about you?
Dr. Charleston: I'm good. I just want to ask something. So, I got a call from our billing office and they said that we have several patients the past month who had claims denied by the insurance because their coverage was terminated.
Alice: Oh my....
Dr. Charleston: So I have asked other staff and they said you were the one assigned in the front desk for the past month.... Have you verified the patients' insurances before I saw them?
Alice: Oh, not really... I forgot about it. I just went ahead and asked them to fill-up information and got their insurance cards... I totally forgot that I had to call the insurance to ask if the patients' policy was active...
Dr. Charleston: I see... Please keep in mind that we always have to check if the patient has insurance, or else, we won't get paid if we forgot to verify.
Alice: I am so sorry, Doctor.
Dr. Charleston: Hello, Alice. How are you?
Alice: I'm good, Dr. Alice. How about you?
Dr. Charleston: I'm good. I just want to ask something. So, I got a call from our billing office and they said that we have several patients the past month who had claims denied by the insurance because their coverage was terminated.
Alice: Oh my....
Dr. Charleston: So I have asked other staff and they said you were the one assigned in the front desk for the past month.... Have you verified the patients' insurances before I saw them?
Alice: Oh, not really... I forgot about it. I just went ahead and asked them to fill-up information and got their insurance cards... I totally forgot that I had to call the insurance to ask if the patients' policy was active...
Dr. Charleston: I see... Please keep in mind that we always have to check if the patient has insurance, or else, we won't get paid if we forgot to verify.
Alice: I am so sorry, Doctor.
