3.3A

Name
Professor
Course
Date
3.3A
The verification of insurance should be done before medical services are offered. The first step Lewis would take to verify Sylvia Baker’s insurance is contacting her insuring company. Considering only the information on the card is risky because the insurance coverage might have changed. Calling Baker’s insurance company will clarify things and make work more comfortable for the medical billing and insurance clerk. An alternative step Lewis would take is doing a follow up on Sylvia by asking or informing her of any changes regarding the cover.
The claim made by Mark might have been rejected because of reasons such as;
Provision of incorrect- In the insurance contract there is a clause that obliges the policyholder to open up on every detail required by the proposal. If there is even a slight discrepancy in the information provided by the insured, then the insurance company has the right to reject any claim made (Glover). Maybe Mark failed to mention a crucial detail when signing his contract with the insurer.
Non-covered charges- it likely that his health insurance policy did not cover the procedure Mark had. Some insurance plans do not include specific categories of care, like dental surgery or infertility treatments.
Bill went to another insurance company- Mark’s doctor might have sent the bill to the wrong company.
On noting that Mr. Flannery’s is quite angry, Lewis should avoid hanging up on him but instead listen before attempting to defuse the matter.

Usually, after giving a turbulent client time to express themselves, they end up apologizing and allow the company to solve the problem. Therefore Lewis should remain calm to prevent the issue from escalating. And once it is time to take action Lewis should provide Mark with an option that will make him feel more in control.

Works Cited
Glover, Lacie. “5 Reasons Your Health Insurance Plan Will Deny Your Medical Claim.” NerdWallet, 21 June 2017, www.nerdwallet.com/blog/health/managing-health-insurance/5-reasons-health-insurance-plan-deny-medical-bill/. Accessed 3 Oct. 2018.