If a patient requests to submit a claim for a new PPO insurance plan starting tomorrow, what should you do?

The appropriate course of action when a patient requests to submit a claim for a new PPO insurance plan that starts tomorrow is not to cement the crown immediately and deny the request. Instead, it is important to consider the timing and effective date of the insurance coverage when assessing the claim submission.

Submitting a claim based on a plan that has not yet begun can lead to complications and potential denials by the insurance company, as services rendered before the coverage becomes active are typically not eligible for reimbursement. The correct approach would involve communicating with the patient about the implications of their request and possibly advising them to wait for their insurance coverage to officially begin before submitting any claims for services rendered.

In addition, if there is any uncertainty regarding the coverage or the types of services that will be eligible, contacting the insurance company for clarification on the specifics of the policy would further ensure that the right steps are taken. This not only aids in avoiding unnecessary denials but also serves to maintain good professional ethics and patient trust.