Create one row for each cost issue: network status, deductible, copay, coinsurance, out-of-pocket maximum, prior authorization, medical-necessity review, covered service category, exclusions, and any balance-billing exposure. Beside each answer, identify the source as insurer member services, insurer utilization management, facility representative, plan document, or personal estimate. Save the representative's name or identifier and the call reference number when available.
Use confirmed only when the relevant source has directly answered the precise question. Use estimated when a calculation depends on an unconfirmed allowed amount, duration, authorization, or service category. Use needs review when sources conflict or a representative cannot determine the answer. For Living Longer Recovery, mark insurance participation, contracted status, current availability, admission, and fit as needs review until directly addressed. Public records alone do not answer them.
- Write each question in its own row so one confirmed answer does not make unrelated assumptions appear confirmed.
- Add a date and source to every figure, including deductible progress and out-of-pocket spending.
- Keep insurer statements, facility statements, and your calculations in separate columns.