01
What to ask the office
The access team can help you identify the questions that need to be confirmed with your current plan.
- Whether the practice and the expected clinician are currently in network
- Whether your plan requires a referral before an evaluation
- Whether records, imaging, or prior authorization are needed before a visit or procedure
- Which costs may remain your responsibility under your deductible, copay, or coinsurance
02
Verification is not a payment guarantee
A benefit check reflects the information available when it is performed. Final payment depends on the plan, eligibility on the date of service, medical-necessity review, authorization rules, coding, and the services actually provided.
If a procedure is discussed after evaluation, ask for a new verification that is specific to that plan of care.
03
If you are referred
Ask whether your plan requires a referral and confirm that the referring office has the correct secure route for records. Do not send medical information through a general website form or an unconfirmed email address.