A verification is a set of facts on a visit, each of them said out loud by a representative, with the recording behind it.
Where it happens
The visit, in Lana. This lesson is part of the Eligibility with Lana track.
What this lesson covers
Step 1
Read the fields
Active or not, plan type, copay, coinsurance, whether the deductible is met, visits used and remaining, whether a referral or a prior authorization is needed, whether telehealth is covered.
Step 2
Find the reference number
It was asked for at the close of the call and read back. It is the first thing an appeal cites.
Step 3
Play the call
The recording is kept with its transcript, so any single fact can be checked against the words that produced it.
Step 4
Check the read-back
Every identifier was read back and confirmed before a question was asked, so the answer is about the right person. A verification that quietly ran on the wrong member ID is worse than none.
After this lesson
You can read a verification, find its reference number, and check any one fact against the recording.
The Academy keeps a record of what each person has completed. It is a record, not a credential: auro accredits no one, and no lesson carries CE or CEU credit.
