Verification of Insurance Coverage Form

Instructions

It is critical that you verify insurance coverage before any service is provided to a patient. Make periodic updates to ensure that the coverage is still effective and that your records are accurate. Patient coverage is the key to your reimbursement. This form should become part of the official patient record. A place is included on the form to record any follow-up calls. You may want to modify the form to satisfy the needs of your particular office.

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• Verification of Insurance Coverage Form