find the

Review Of Insurance Cards

in this lesson we'll review various

types of insurance cards including some

of the common ones you might see

patients come in with you'll also be

able to print out a job aid on becoming

familiar with insurance cards with an

overview of the key information to look

for as shown in this lesson as a result

you'll be able to identify cards and

where to find key information describe

the four parts of Medicare and

distinguish an HMO card from other

insurance cards medicare covers adults

65 and older qualified younger adults

with disabilities and those with in

stage renal disease the Medicare program

has four parts it's important to verify

which Medicare Parts A patient has all

people eligible for Medicare get Part A

most people purchase Part B coverage as

well part a is for hospital inpatient

coverage Part B covers doctor visits and

some vaccines Part C is when Medicare

reassigns their a and B benefits to Part

C when they do this the patient no

longer has Parts A and B they have C

instead think a plus B equals C Part D

is for prescriptions will review Part D

in a moment

this is a traditional Medicare card it

shows coverage for both Part A hospital

care and Part B doctor visits as of 2013

the Medicare ID is the patient's social

security number plus a letter this may

change in the future this is a sample

Medicare Advantage card for Part C

remember that's equal to Parts A and B

together some Advantage plans may also

cover Part D prescriptions if you're not

sure you'll have to check the patient's

plan and current benefits the advantage

card is issued by a private insurer that

contracts with Medicare in this case

Blue Cross Blue Shield the arrow shows

that the card says Medicare Advantage

PPO it also shows the subscriber number

for Chris Hall and the group number both

pieces of information you may need if

you have to check on this patient's

coverage or Benefits contact information

for the insurer is usually on the back

side of the card

this is a sample card for Medicare Part

D which covers prescription drugs and

certain vaccines sometimes it's called a

Medicare supplement card or a pharmacy

card like Medicare Advantage Part D

cards are usually issued by a private

insurer contracting with Medicare in

this case Health Net the look of the

card may vary but it will always show

the patient's name ID number group

number and effective date of service

information on how to contact the plan

is usually on the back side of the card

if a patient presents for immunizations

and has Medicare ask them for the card

they give to their pharmacy

here's an example of a medical card it's

sometimes called a bi C card meaning

benefits identification card it lists

the patient's unique medical ID number

name sex date of birth and issue date

with the exception of infants 30 days

old and younger

each participant should have their own

card per medical guidelines it's a good

policy to request the card and verify

the person's ID this is a sample private

insurance card for BlueCross BlueShield

while plans and cards vary greatly

they have several things in common the

card lists the patient's name and unique

ID number typically for Blue Cross the

ID number will begin with a three-letter

code that identifies the subscribing

company to the health plan there will be

a group number a plan number and

effective dates often it will list that

the plan is a PPO or preferred provider

organization generally PPO plans require

your clinic to have a contract in place

in order to receive payment that will

allow you to build them as an

out-of-network provider if your

department has a contract with the

insurer you should build patients at the

in-network rate if you have no contract

you should check to see if the patient's

PPO plan includes out-of-network

benefits that means the patient's

insurance should be valid at your clinic

this is a sample HMO card meaning health

maintenance organization you can usually

recognize HMO cards because they should

include the letters HMO on the front

it's helpful to be familiar with common

local HMOs like Kaiser the most

important thing to know is that most of

the time HMOs will not pay their

enrolled patients to go to an outside

provider including the health department

that's because HMOs already pay their

network doctors a monthly set rate also

called a capitated rate to give

immunizations and provide other services

in rare circumstances a local HMO may

contract with the health department for

specific services or allow a member to

get a one-time service in such a case

the client must have a written

authorization from the HMO noting the

specific service and date range it's

valid now please follow the instructions

to take the quiz for this lesson

it'll look familiar it's the same one

you took before viewing a lesson this

time you'll be able to see the correct

answers as you respond to demonstrate

what you've learned after you've

completed the quiz you may continue at

your own pace to view subsequent lessons

at your convenience the lessons are

ordered so you'll build your knowledge

of each part of the billing process that

relates to your role when you finish all

the lessons you'll be able to print out

a certificate of completion to reward

your efforts thanks for your attention

please continue on to the quiz