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Insurance

Billing health plans: turning it on, the payers you bill, a client's policies and eligibility, claims, and posting what a payer pays.

18 articles

Articles

  1. Insurance from start to finishFollow one client through insurance billing: set up, the client's policy, eligibility, rates, the claim, the payer's payment, a denial, a second payer and the client's share.
  2. Turning on insurance billing and adopting payersChoose whether your practice bills health plans, adopt the payers you bill, and open the registrations they need.
  3. Recording a client's insurance and checking eligibilityRecord the policy that pays for a client's care, correct or end it, and ask the payer whether it is in force.
  4. Turn on insurance billing and adopt payersChoose whether your practice bills health plans, adopt the payers you bill and open the registrations they need.
  5. Record a client's insurance and cardWrite down a client's policy from their card, or record it from what the client told the practice, and correct or end it later.
  6. Assembling and sending a claimAssemble a claim for a finished session, correct it on a form shaped like the CMS-1500, run the checks and send it to the payer.
  7. Check a client's eligibilityAsk the payer whether a policy is in force and what copay, coinsurance and deductible the client has left.
  8. Recording and posting an insurance paymentType in a paper explanation of benefits, then post a payer's payment onto your clients' balances.
  9. Record contracted ratesPut each payer's agreed amounts on file by hand or by uploading a spreadsheet, and correct a rate that changed.
  10. Find unbilled appointments on the Work tabUse the Work tab to see finished appointments that have no claim, claims waiting on a person and payments not yet posted.
  11. Assemble and send a claimTurn a finished appointment into a claim, correct anything the checks name, send it to the payer and follow its progress.
  12. Review and post an ERARead what the payer paid and took off, match any row that matched no claim, post the payment and withdraw one that never arrived.
  13. Fix a rejected or denied claimRead why a claim came back, correct it and send it again, replace or cancel it, or write off what is left.
  14. Bill the second insuranceBill a client's other payer after the first has answered, with the first payer's payment and adjustments carried onto the claim.
  15. Bill the client their shareRaise an invoice for the copayment, coinsurance, deductible or other amount the payers left with the client.
  16. Tracking claims and reading their statusesRead the claims list, follow a sent claim and check what is still outstanding.
  17. Working the unmatched inbound queueRead items that matched no claim and tie an answer to the right claim.
  18. Checking a payer's enrollment and your clearinghouseRead payer registrations and find the clearinghouse selected for the practice.