Instructions:

Insurance plans are structured to provide quality medical care while attempting to limit healthcare costs.  As part of this structured plan, there are specific processes that must be completed so that reimbursement can occur. Patients often need services or examinations that require a health care provider to verify eligibility for those services.  You will be doing a role play in which you demonstrate how you would verify insurance eligibility.

John Q. Smith was injured while competing in a rodeo as a bull rider and has requested to be seen by your physician.  Your job is to call Mr. Smith to collect information in order to verify eligibility for insurance. 

Assignment:

1. Read the following web based document: Checking Patient Eligibility: Saving Time & Money (Webpage). 

 2. Ask someone to role-play this phone call with you.

3. Your job in the role play is to phone John Q. Smith and try to obtain the information necessary from him so that you can complete this Patient Information Sheet which you will then use in the next Competency Assessment to enable you to call the insurance company to verify eligibility.

4. Videotape the role play of you calling the patient and submit it to be graded.