Why is it important to know patient's insurance info?

[Despareux]

One of my preceptors told me she looks up insurance information for every one of her patients. She didn't explain why, but told me I would figure it out soon enough.

So what did I miss, because I can't figure out why knowing my patient's insurance information is important.

[VICEDRN, BSN, RN]

I have no idea.

I have never met a nurse or doc who does this in the ER unless a particularly expensive medication is prescribed at discharge...In this case, the MD checks with the patient to ensure that the patient can afford to fill it prior to discharge. We don't check the chart because this can lead to sticky questions about fraud.

Your preceptor sounds less than inspiring...

[KelRN215, BSN, RN]

What environment are you working in? I never considered what insurance my patients had when I worked in the hospital (unless we were discussing referrals to home care or rehab). But what insurance they had had absolutely no bearing on the care I provided to them as a bedside nurse.

[whichone'spink, BSN, RN]

Perhaps your preceptor perceives people of a certain insurance type to be d-bags, so she checks patients' insurance to confirm her bias. It's not important to know what insurance patients have. That's the job of the case manager when he or she is trying to pull together resources.

[Ruas61, BSN, RN]

Do you work for Fairview systems in Minnesota? They had financial counselors sourced in to help gather revenue. Big ruckus here.

[tokmom, BSN, RN]

I check insurances, but I also do discharges and work closely with URDP, so it's imporant. I also take note of the self pays for perscription/charity med reasons.

[Dixielee, BSN, RN]

We don't even have access to the information regarding insurance. It doesn't matter to me if they are insured or not. They get the same care regardless. Unless your job is in the billing department, then I don't see where it matters at all.

[llg, PhD, RN]

Does your work involve choosing treatments for patients? If so, knowing their insurance will help you pick the treatment that will cost them the least money. For example, Insurance A might prefer that their patients use a specific drug and cover the expenses of that drug 100% -- but if you choose drug B (equally effective), the insurance may only cover 80% and the patient may be stuck with a significant co-pay.

The same economics play out with other treatments, lab tests, post-discharge services, etc. Insurance companies often "dictate" the specific orders by making some choices expenses and other patients cheap. A good physician or NP will take do their patients a favor by taking the finances into consideration as they write their orders. They'll help their patients (and promote compliance) by choosing the cheaper options when reasonable -- or at least asking the patient their preference.

Years ago, when my father was a resident ... one of his mentors required him to write the cost of any test he ordered as part of the order. That forced my dad to consider whether or not the test was really worth the expense to the patient, who would ultimately would be paying for that test or treatment.

Could that be the reason?

[Nursetastic]

I work ICU and couldn't care less what insurance (if they have any) my patients have. Regardless of ability to pay, may patients deserve the very best care I can give.

[Despareux]

I'm not in billing or anything like that. The insurance information is in the patients charts. I just thought it was strange and never felt it had any bearing on the care I provide for my patients. Thanks for the responses; I'm glad I'm not missing out on anything pertinent.

[Esme12, ASN, BSN, RN]

It has no bearing on the bedside care of the patient for the average nurse unless she is interacting with Case management.

[Been there,done that, ASN, RN]

I would ask the preceptor how this will benefit the patient and improve your care.

I have 30 years of bedside nursing.. never had the inclination or the time to check.

Now that I am in a managed care position .. I can see how that information may benefit the patient when the bill comes and of course the PROVIDER and PAYOR.

But in the real world... that is something bedside nurses cannot possibly add to their already overflowing plate.