Where to find the group number on insurance card
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
