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IMS Health Standard Companion Guide Health Care Eligibility/Benefit Inquiry and Information Response (270/271) Refers to the Implementation Guides Based on ASC X12N Version 005010×279A1June 2019 DRAFT

How to fill out health care eligibilitybenefit inquiry

How to fill out health care eligibilitybenefit inquiry

1. To fill out a health care eligibility benefit inquiry, follow these steps:
2. Gather all the necessary information such as personal details, insurance policy information, and medical history.
3. Start by filling out the patient's demographic information including their name, address, contact details, date of birth, and social security number.
4. Provide information about the insurance coverage, such as the insurance company's name, policy number, group number, and any specific plan details.
5. Describe the reason for the inquiry, whether it is to check eligibility, confirm benefits, or request prior authorization for a specific medical procedure.
6. Include any relevant medical history or documentation that supports the need for the inquiry.
7. Ensure that all the information provided is accurate and up-to-date.
8. Double-check the completed form for any errors or missing information before submitting.
9. Once the form is filled out completely, submit it to the appropriate health care provider or insurance company either electronically or through mail.
10. Keep a copy of the filled-out form for your records.
11. Follow up with the health care provider or insurance company to ensure that the inquiry is being processed and that you receive a response.

Who needs health care eligibilitybenefit inquiry?

1. Health care eligibility benefit inquiries are typically needed by individuals or their authorized representatives who want to determine their eligibility for specific health care services or confirm their insurance benefits. This can include patients who require a medical procedure, therapy, or medication and want to check if it will be covered by their insurance, individuals seeking to explore their options for health care coverage, or those needing prior authorization for certain treatments. Health care providers may also initiate an eligibility benefit inquiry on behalf of their patients to ensure proper coverage and reimbursement.

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What is health care eligibility/benefit inquiry?

Health care eligibility/benefit inquiry is the process of verifying a patient's eligibility for health care services and determining the benefits available under their insurance plan.

Who is required to file health care eligibility/benefit inquiry?

Health care providers, insurance companies, and patients may be required to file a health care eligibility/benefit inquiry depending on the situation.

How to fill out health care eligibility/benefit inquiry?

Health care eligibility/benefit inquiry forms can typically be filled out online, over the phone, or in person by providing the necessary personal and insurance information.

What is the purpose of health care eligibility/benefit inquiry?

The purpose of health care eligibility/benefit inquiry is to ensure that patients are eligible for services and to determine the coverage and benefits available under their insurance plan.

What information must be reported on health care eligibility/benefit inquiry?

Typically, health care eligibility/benefit inquiry forms require information such as the patient's name, date of birth, insurance policy number, and the services being requested.