A patient is scheduled for an elective surgical procedure. Before the date of the surgery, which of the following actions should a medical assistant take to ensure compliance with the insurance provider's requirements for coverage?
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Verify the patient's insurance eligibility on the date of the surgery.
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Contact the patient's insurance company to confirm the amount of the patient's copay for the procedure.
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Post charges for the surgical procedure to the patient's account in the office billing system.
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Obtain a prior authorization for the surgical procedure from the patient's insurance provider.
The correct answer is obtaining a prior authorization for the surgical procedure. Insurance companies often require this authorization as part of their policies to approve coverage for certain services, like elective surgeries. By securing a prior authorization, the medical office ensures that the cost of the procedure will be covered by the patient's insurance plan. Not verifying insurance eligibility only confirms if the patient has an active insurance policy but doesn't guarantee coverage for specific services. While contacting the insurance company to confirm the patient's copay is important, it is not sufficient on its own to ensure coverage of the procedure. Posting charges involves updating the patient's account after the services have been rendered, which is not directly related to obtaining approval for the surgery.
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