Case Study: The medical assistant must call

Case Study: The medical assistant must call a patient’s insurance company. The insurance company is denying payment on a needed procedure. The call is taking place between checking in patients who are in for appointments. After speaking to the insurance company and providing details from the patients’ medical record the insurance company decides to cover a lower level procedure not what the provider ordered. The medical assistant must now speak to the provider regarding the service. They must explain the third -party requirements to the provider. Questions Describe how you would plan to interact professionally with third party representatives even as they are not agreeing with the providers recommendation. (VIII.A.I) Describe how you would display tactful behavior when communicating with medical providers regarding third-party requirements. Keep in mind providers are nit savvy when it comes to insurance policies and clearly want the best for their patients. (VIll.A.2) How would you protect the integrity of the medical record given you must conduct the call during office hours while other patients are checking in. (X.A.2)

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