Adding Insurance Plans to a Carrier

Insurance Plans are added and managed from the second tab (Insurance Plans) of the Insurance Carriers form (Billing Lookups > Carriers/Insurance Plans).

Find and open the Carrier for the plan you want to add or modify. If the Carrier does not yet exist, you can add a new Carrier.

After the Carrier form displays, click the second tab (Insurance Plans). The current plans for the selected Carrier appear in the list. If you want to view or modify a plan that is already in the list, just double-click it. To add a new Insurance Plan, click the New button just above the Insurance Plan list, or click anywhere in the list and press <CTRL><N>.

At the top of the Insurance Plan form is a required field for the Plan Name, plus a Contact, and some Remarks. Next to those fields are a set of drop fields in which you can select an address, a phone number, and an email address for this plan. The selections in the drop list come directly from the Communications list on the main Carrier screen. If what you want is not already present in the drop list, use the New button at the bottom of the list to add a new selection with the needed information. Note that if you add a new entry to any of these drop lists, whatever you add will also appear in the Communications list on the Carrier screen.

 

Next, there are two panels containing fields that match fields just like them on the main Carrier form. You will probably notice that default values taken from the Carrier form automatically populate these fields. Just change whatever needs to be different.

At the bottom of the Plan form are a set of fields that allow the software to calculate the appropriate patient portion of your fees. These are the values that often differ from plan to plan among those offered by the same Carrier, so communication with the payer is often required to determine how these fields should be completed.

Once a new Plan has been saved, and the Plan’s Carrier has also been re-saved, you will be able to go back into the Plan to specify Plan Exceptions.

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