Weâve broken this guidance up into small, digestible chunks. Youâll find links to the other steps at the bottom of the page.
Once you have Set up your Insurer Folders in Jane and created your Billing Codes you can get cracking with creating your Patient Policies. â To do this, you can either hop over to your Patientâs Profile or create a policy right from the Appointment Panel in your diary.
From the Patient Profile
From the Patient Profile, you can begin by heading to the Billing tab > Insurance Policies > New Insurance Policy.
From the Appointment
If you would like to enter a patientâs insurance information from the main diary, follow the steps below:
1) Click on the patientâs appointment in the Diary 2) In the Appointment Panel, scroll down and click to open the Insurance Info area 3) Click on the âAdd Policyâ button, and then select âAdd New Policyâ
Regardless of which way you start, the process from here is exactly the same.
First up, select the relevant Insurer/Third Party for the patient:
Next, you can optionally give the policy a nameâthis is for internal use, and should be useful in identifying the policy.
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The only mandatory field is the Claim Number / Authorisation Code / Pre-Authorisation Number. The information in this field will display on all invoices for this policy.
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The âPolicy / Membership / Registration Numberâ field is optional in Jane. If you enter information in this field, it will display on all invoices for this policy.
Youâll find some more optional fields further down the page, many of which can be really useful in keeping track of where a patient is at with their treatment. In the below example, Iâve entered the maximum number of treatments authorised in the policy, the policy end date, and the date of the patientâs injury. Jane then knows to flag up and alert you when the patient has reached the maximum number of treatments, or the policy reaches its end date đ¨
You can also add contact details of the insurance company, or the case manager youâre liaising with (if applicable).
Further down the page again, youâll find the default billing options. We find that the majority of clinics simply leave the defaults as they are, as they may not know the specific details of the patientâs excess until theyâve submitted the first invoice to the insurer. The default settings let Jane know the insurance company are covering 100% of the invoice.
If you do know the patientâs excess up front, just pop it in the âExcessâ field. Similarly, if youâre working with an insurer who cover a specific percentage of the invoices (e.g. 80%), you can change the default to the relevant amount.
Otherwise, stick with the default options and hit Save when youâre ready.
The New Insurance Policy will now show up under the patientâs Insurance Policies area.
And in the Appointment Panel in your diary:
Nice work, you just created your first insurance policy! đ
Healthcode and Insurance Policies
The good news is that if youâve read through the information above then youâre in a good place as things arenât really any different when it comes to Healthcode. Phew, I hear you say.
So, although things donât really change when it comes to adding policies under Healthcode, there are a couple of things to bear in mind.
We have implemented some validation rules to ensure that all generated files contain the information that specific insurers would like to see. This means that the following fields will need to be completed within the Insurance Policy in order to pass validation.
Claim Number/Authorisation Code/Pre-Authorisation Number Policy/Membership/Registration Number
If any of this information is missing, then Jane will catch that when trying to generate the submission file, but more about that later.
Next up, weâll look at adding the policy and billing codes to appointments. This is where youâll start to see all your progress in action.
You can navigate to any section of this guidance using the links below:
- Step 1 - Setting up Insurers
- Step 2 - Billing Codes & Contract Rates
- Step 3 - Insurance Policies
- Step 4 - Insuring an Appointment
- Step 5 - Invoicing & Payments
Written by Jamie - UK Support Team