2014 Hotline Success Case 3: Account Education, Successful Verification of Benefits and Pre-determination Assistance

The GIRS InContact Reimbursement Line™ found that an Insurance Verification Request (IVR) did not have the primary payer information for a case.  The hotline worked with the account by educating them on the IVR and the importance of providing the key data. The account then updated the IVR information and the hotline was able to use the updated information to verify coverage based on Pre determination.  The hotline then followed up with the account and the payer to ensure that the Pre determination was submitted by the account within the specified timeline and with the payer-requested information.  The reimbursement support service provided by the hotline helped the account to verify benefits prior to treatment and also to ensure that they follow all payer guidelines for claims submission.