Preferences - Insurance

The Insurance preference allows you to customize a number of insurance settings, including enabling insurance estimating, and also set providers to default accept assignment and default participates.
General Tab
  • Use Insurance Estimating: If checked, the Patient Portion on the ledger will immediately reflect the estimate after a charge is made.
    • NOTE: Before turning this preference on, it is recommended that you read through the Insurance Estimating documentation. If you do not, your estimates will not be correct.
    • When disabled, charges will be added to the Patient Portion until an insurance claim is created. Once the charge has been submitted on an insurance claim, the charge's balance may be moved to the Insurance Portion, depending on the configuration of the insurance company's reference. For more information on Patient and Insurance Portions allocate when you are not using Insurance Estimating, please see our documentation on ledger portions. Once the insurance pays, the remaining balance is moved back to Patient Portion.
  • Assume 100% coverage for patients who have no insurance plan configured: When checked, assume 100% coverage, up to the remaining coverage. Otherwise assume zero coverage even though there is remaining coverage.
  • Print insurance estimating description line on account statements: When checked, print the estimated patient portion on charges that are on outstanding claims. This is only printed if insurance estimating is on.
  • Assume 100% coverage on charges with no procedure type: When checked, a charge without a procedure type is assumed to be covered 100% by insurance estimation. Otherwise assume 0% coverage. This also sets the default percentage coverage when you create a new plan in the insurance reference.
  • Duplicate plans when duplicating insurance companies: When checked, provider ID's, plans, and allowed amounts are all duplicated when you duplicate an insurance company.
  • Duplicate allowed amounts when adding new insurance plans: When checked, the new plan will include a copy of the allowed amounts from the previous selected plan.
  • Automatically set start and end dates for insurance: When checked, the start and end dates will be automatically filled in after replacing an existing insurance with a new insurance. If the old insurance is tied to claims, then the end date of the old insurance will be set to today, and the start date of the new insurance will be set to the plan's start date, or today if the plan doesn't have a start date.
  • Automatically set the insurance start date to today: When checked, after adding a new insurance or retrieving an archived insurance in primary/secondary, the start date is set to today.
  • Set insurance start date as required field: When checked, you must have a non-blank insurance start date before saving the patient.
  • Account for adjustments in CMS-1500 form Box 28: When enabled box 28 (Total Charge) should account for the adjustments on the charge. For example, a charge with a fee of 100.00, a negative adjustment of 20.00, MacPractice will print 80.00 in Box 28.
  • Disable newly added insurance: When enabled newly added patients insurance records are disabled. They must be checked explicitly on the Patient > Insurance tab. This allows you to confirm the insurance information is correct before you start to submit claims to their insurance company.
  • Deduct estimated write-off from open balance: When enabled, if you have Insurance Estimating turned on, this preference will deduct any estimated write off from the charge's open balance. Making this change requires a log out and back in. You can read more about this new preference here, as it has implications for how open balances are handled in the ledger. 
Other Tab
From the Other tab, you can set the number of days before receiving alerts in reports, Claim Manager, and eClaims regarding your timely filing limit.
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