A patient with a managed care insurance plan arrives at a clinic for a follow-up appointment after receiving orthopedic surgery. Before seeing the physician, which of the following steps should the medical assistant take to ensure the visit is authorized under the patient's managed care policy?
Check the patient's account for outstanding balances from previous visits
Confirm that the patient's managed care insurance has authorized the post-surgical follow-up appointment
Prepare an Advance Beneficiary Notice (ABN) for the patient to sign, indicating potential charges
Request a referral from the patient's primary care physician
For patients with managed care insurance plans, medical assistants must verify that a follow-up appointment, especially after a specialized service like orthopedic surgery, has been authorized by the insurance provider. If the medical assistant fails to confirm this authorization, the patient may be responsible for the cost of the visit, or the provider may not be reimbursed by the insurance company. Referral confirmation would only be necessary if the patient were being sent to see another specialist rather than returning to their original provider.
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