Patient Kenya Hilbert arrives for an appointment and gives the medical assistant, Portia Milstine, MA, her insurance card. Portia notices that the insurance company is Healthy Way Insurance and that Ms. Hilbert works for the Exact Accounting Company, a large company near the medical clinic. She recalls that this morning Josiah Campbell came in and that he also had Healthy Way Insurance and also works for the Exact Accounting Company. When she verified his benefits, she learned that preventive care is covered at 100 percent, and for other services, patients must pay a $20.00 copayment. The office is busy this afternoon, so Portia wonders if she really needs to take the time to verify the benefits for Ms. Hilbert. After all, it looks like she has the exact same insurance that Mr. Campbell had, and she already verified his benefits. Is it necessary to verify the benefits for Ms. Hilbert because she has the same insurance company as Mr. Campbell and they work for the same company? Why or why not?

What would happen if Portia told Ms. Hilbert that her visit today will be covered 100 percent by her insurance company, based on what she learned about Mr. Campbell’s insurance with the same company?

What methods could Portia use to verify benefits?