Insurance Verification (Phone Check)

Service Description

Designed for complex cases where portal data is insufficient or detailed authorization limits must be confirmed directly with a representative. This service provides exhaustive manual phone verifications completed 3 to 5 days prior to the Date of Service (DOS). Deliverables: Detailed benefit breakdowns and confirmation of exact coverage limits. Identification of Primary and Secondary payers and Coordination of Benefits (COB). Direct documentation of all call findings, limitations, and reference numbers into your EMR. Service Guarantee: I guarantee a standard of 100% accuracy on all manual phone checks. In the event of an error, the file will be re-verified at no additional cost. Terms of Agreement & Operations: Client Obligations: The Client agrees to provide active access to the EMR system and accurate patient demographic data. For phone checks, the Client must ensure I am listed as an authorized representative or have the necessary NPI/Tax ID details to speak with payers on the clinic's behalf. Contractor Status: I operate strictly as an Independent Contractor. This service does not create an employer-employee relationship. I am responsible for my own hardware, secure internet connection, and tax liabilities. Compensation & Payments: The fee is $4.00 per manual phone check. Any verification requested with less than 3 days' notice is classified as a "Rush Request" and incurs a 50% surcharge. Invoices are based on the volume of completed calls and are due per the agreed invoicing schedule. Data Security & Privacy: Strict HIPAA compliance is enforced. All patient data, call logs, and PHI discussed during payer calls are handled with maximum confidentiality and documented securely within the Client's specified EMR system. Non-Solicitation: During the term of this service and for a specified period after its conclusion, neither party shall attempt to solicit, poach, or hire the other party's staff, contractors, or active clients. Term, Selection & Termination: This service agreement is effective upon booking. It remains active until either the Client or the Contractor provides written notice of termination, subject to the timelines established in our formal working agreement.