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Join Susie & Kristen as they role play how to call an insurance rep to verify benefits. Copy & paste our "Cheat Sheet" below into your own documentation system to keep yourself calm, collected, and on track while you call!


Ready, Set, Treat! Cheat Sheet to Verify Benefits


Things to have in prep to call insurance company:


1. Individual & PLLC NPI

2. PLLC fax & phone number

3. Client & Subscriber Name

4. Client & Subscriber DOB

5. Client Member ID

6. EOBs (if calling in regards to a past claim)


What to ask:


1. Is outpatient <your discipline> a covered benefit?

2. Any caps to yearly visits? Combined with any other discipline?

3. Referral or Prior Auth Required? (If needed, where to find Prior Auth Form?)

4. Any deductible remaining?

5. Once deductible is reached, any copay or coinsurance?

6. Rep’s name & reference #


*DOCUMENT this convo in the Billing section of your EMR!

Hot Topic: Verifying Insurance

  • A note to the Participant or Purchaser:

    While the information contained in these courses and products is accurate and up to date to the best of our knowledge, state and federal laws vary greatly and change frequently, with each discipline and insurance contract also having its own set of unique rules. The information contained in these courses intended to be a guide, with the understanding that it is the reader’s responsibility to consult his or her attorney, accountant, insurance contracts, state department of business, and state and national licensure laws and requirements in order to conform to current state and federal laws and regulations as they relate to his or her scope of practice.

    Copyright 2021, Ready, Set, Treat!, LLC

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