Insurance Estimating - Quick Reference

For a quick Insurance Estimating reference, use this worksheet to configure and troubleshoot insurance estimating.

On the Guarantor (Primary or Secondary)
  Enter the Insurance.
  Enter the Subscriber and Group ID, if applicable.
  Select the Plan.
  Verify the Start Date is before the first procedure date.
  Verify the Renewal Date.
  Do not enter an End Date unless coverage terminates.

On the Patient
  Verify the Annual Coverage.
  Verify the Deductible.
  Verify the insurances are correctly ordered (Primary first) in the Insurance tab.

On the Plan
Coverage Tab
  Verify that the Annual Coverage is correctly set.
  Verify the Participate status.
  Verify that the Percentage is set per Procedure Type.

Allowed Tab
  Verify that the Allowed amounts are correctly entered.
  If not, use the Update Fees menu to select "Copy from Other Plans".

If estimates are incorrect
  Verify the patient has a plan.
  Verify the procedures are set to the correct Procedure Type.
  Verify the patient has Remaining Coverage under the Patient > Insurance tab.
  Verify the charge is applied to the patient's deductible or copay.
  Verify the coverage percentage and allowed amount are correct.
Was this article helpful?
0 out of 0 found this helpful