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Eligibility, Payment, and Billing Procedures

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Eligibility, Payment, and Billing Procedures
Eligibility, Payment, and Billing Procedures

When a health care practice is providing medical services to their patients its essential that they are aware of how the patient is going to pay for the services they receive. The main resource that patients use to pay their medical finances is health insurance. When a patient is covered by health insurance they are required to provide their health provider with the necessary proof of what their health insurance coverage entails. Afterward its the health provider's objective to verify the benefits that the patient is eligible for concerning their health care coverage. All health insurance is different some insurance providers obligate the patient to pay a higher premium with low or no co-pay cost, and then other health insurance providers ask the patient to pay a low premium with a higher co-pay than others. There are a sum of factors that determines whether or not if a patient is eligible for health care benefits such as premiums not being paid accordingly, employment changes, and sudden changes with the health coverage. There may also come a time when the insured patient's insurance doesn't cover the cost of a planned service. In the matter of this event happening the patient will be informed that their insurance payer will not be covering the cost of the planned services, and that they will personally be responsible. Sometimes the insurance provider will require the health provider to inform the patient of this matter through a written form that must be signed by the patient to verify their understanding that they are responsible for the cost when their insurance isn't required to pay. The patient should always be aware of the services that are eligible to receive through their insurance so that there isn't confusion when it comes to paying for the services received. The health provider will determine what the insurance payer is entitled to pay, and then they will bill

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