Office Administrative Assistant Practice Exam

Which of these ensures that routine, as well as special procedures and services, will be covered by insurance?

1. Verifying coverage and benefits

2. Reviewing patient history

3. Submitting routine claims

4. Consulting insurance agents

The correct answer is: Verifying coverage and benefits

Verifying coverage and benefits is essential in ensuring that both routine and special procedures are covered by insurance. This step involves checking the patient's health insurance policy to determine what services are included, what the co-pays or deductibles are, and any limitations or exclusions that might apply. By confirming these details before procedures are performed, administrative assistants can provide patients with accurate information regarding their financial responsibilities. This practice not only enhances patient satisfaction by reducing unexpected costs but also streamlines the claims process, as both the provider and patient have a clear understanding of their financial obligations and what the insurance will cover. In contrast, reviewing patient history focuses more on the medical background and conditions of the patient rather than confirming insurance coverage specifics. Submitting routine claims is part of managing billing but doesn't ensure coverage; it merely follows the procedures after verifying insurance eligibility. Consulting insurance agents can provide additional information, but it is the verification of coverage and benefits that directly addresses the issue of what will be covered by insurance in relation to specific procedures and services.