Below is sample scripting written for members of the patient access staff to handle pre-registration of patients at Huntsman Cancer Center, which is based in Salt Lake City, UT:
Financial counselor: Hi, I’m calling from University Healthcare regarding your upcoming endoscopy appointment. May I speak with Mr. Jones?
Mr. Jones: That’s me.
Financial counselor: Great. I am calling you to verify demographic information including your insurance benefits before your endoscopy appointment. This will take about five minutes to go over with you. Would you verify your date of birth, current mailing address, phone number, and emergency contact?
Mr. Jones: Sure. It’s ______, _____, _____, and ______.
Financial counselor: Thank you. I also show that you are enrolled in Regence Blue Cross/Blue Shield. Is that correct? Do you have any other insurance we can bill?
Mr. Jones: No, just Regence.
Financial counselor: Perfect. I’d like to let you know that we have called and verified coverage for endoscopy with your Regence insurance. There will be no prior authorization required, and it is a covered benefit based on medical necessity. Your out-of-pocket responsibility for this procedure will be about $300.
Mr. Jones: How did you come up with that number? Nobody has asked me to pay for endoscopies in the past.
Financial counselor: Sure, let me explain it in more detail. You have a $250 deductible which you have already met for this year. After you satisfied your deductible, the plan pays at 85% until you meet your annual out-of-pocket of $2,500, of which you have met $1,200 so far this year. Our total billed amount to insurance is $2,800 and the allowed charges is $2,000. Since you will still be responsible for 15% after insurance pays, your portion will be about $300. Will this answer your question? I know it’s little complicated. But what’s important here is that based on our calculation of 15%, your out-of-pocket amount is about $300, and it is a covered benefit. We are calling patients to inform them of insurance coverage so there will not be any surprises when they receive the bill.
Mr. Jones: I see. So can I pay $300 with you now, or should I bring it with me?
Financial counselor: I’d be happy to take care of the $300 pre-payment on the phone now. It’s one less thing to worry when you come in for the procedure.
Mr. Jones: OK. Let me grab my credit card. Hold on for a sec.
Mr. Jones: Here’s my credit card number: xxx-xx-xxxx.
Financial counselor: Thank you so much. Let me run your credit card for $300 for your endoscopy. I am sending you the receipt in the mail. Do you have any other questions or anything I can assist you with today?
Mr. Jones: No, I don’t think so.
Financial counselor: Thank you for your time, and we’ll see you on [day/month/year].
