It should outline what information you need from the patient and what they need to provide to you. The body of the letter should be concise and easy to understand. We would like to ensure that we have the most accurate and up-to-date insurance information for you so that we can provide you with the best care possible.” Body As an example: “Dear Patient, I am writing to request information about your insurance coverage. The opening paragraph of the letter should introduce who you are and why you need the patient’s insurance information. Here are some guidelines for the best structure of a sample letter requesting insurance information from a patient. Writing a letter to request insurance information from a patient can be a simple and effective way to obtain the information you need. The Best Structure for a Sample Letter Requesting Insurance Information from a PatientĪs a healthcare provider, it’s important to have accurate insurance information from your patients in order to ensure they receive the medical care they need. If you have any questions or concerns, please do not hesitate to contact our office. Thank you for your cooperation in this matter. We take your privacy seriously and assure you that your information will only be used for billing purposes. Having this information on file will allow us to better serve you and ensure that your claims are processed accurately. This includes the name of your insurance provider, your policy number, and the name of the primary policyholder. In order to ensure that we have the correct information, we kindly request that you provide us with your insurance information. As we prepare for your upcoming appointment, it is important that we have accurate and up-to-date information for our records. It has come to our attention that we do not have your current insurance information on file. This not only speeds up and simplifies the process, it also reduces the likelihood of human entry errors.We hope this letter finds you well. For example, if you have billing software, make the fields on this form match up to the way that you would need to enter the information into your billing software. This form is editable so it can be modified as necessary for your practice. Instructions for Patient Information Form #2:įorm #2 is a DOC file which does include some general insurance information, but it is not specific enough to properly determine insurance verification, therefore, it is best used in conjunction with the Insurance Information or Insurance Verification form(s). ![]() The practice information at the top of the page is editable so be sure to modify it as necessary for your practice. Instructions for: Patient Information Form #1įorm #1 is a PDF file which does not include any insurance information and thus, it is best used in conjunction with the Insurance Information form. ![]() Both forms provide the basic information necessary for all types of healthcare practices. Form #2 is editable so it could be easily modified for your organization. We suggest that you review both and determine which best fits your practice model. We have two different samples for Patient Information Forms. Mar 17th, 2015 - Reviewed/Updated Jun 9th News - industry news & Find-A-Code updates.Marketplace - recommended products & services. ![]() ![]()
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