What is the first step required to verify patient eligibility?

Determining if the insurance is a managed care plan is an important first step in verifying patient eligibility. Managed care plans often have specific guidelines regarding which services are covered, and understanding the type of insurance a patient has allows the medical assistant to navigate eligibility requirements more effectively. By identifying managed care plans, the medical assistant can ensure that the patient's services align with those covered by their insurance provider, which can facilitate smoother claims processing and reduce denials related to coverage.

The ability to recognize the type of plan also informs subsequent steps in the process, possibly influencing whether pre-authorizations are necessary, which services can be billed, and if referrals are required before the patient receives particular types of care. This foundational knowledge helps streamline the overall eligibility verification process.