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Lesson 7: Insurance

Jane University: Practitioner Training

💡Jane Tip: We recommend heading over to Jane’s Demo Clinic to practice as you learn! Contact us to request access. If you are a current Jane user, it’s best not to create fake or test data in your own account as it can be difficult to remove later on.

Lesson 7: Insurance & Billing to a 3rd-Party

In our 7th and final lesson, we’re diving into the wonderful world of insurance billing! Jane helps your clinic manage insurance claims and allows you to send invoices to 3rd-party payers.

Note: The features covered in this chapter are only available to clinics on our Insurance Plan.

Managing insurance claims can work a bit differently depending on where you are located. We’ve divided this final chapter by location, so if you are one of our lovely US clinics, skip on down to the US Billing section to start learning :)

Insurance & Billing to a 3rd-Party

Jane helps you submit and manage insurance claims by paper or through an online portal. To insure visits, there are a couple of things that first need to be set up in your Jane account. The video below will walk you through the full workflow of insurance billing, and shows how all the pieces come together once implemented at your clinic.

Note: The set up of insurance will need to be completed by a member of your team with Full Access.

Let’s review a few basic insurance billing work flows:

Creating Patient Claims

When you’re ready to start saving your patients’ insurance information, we call this ‘creating patient claims’.

This step may be completed by a front desk staff member, should your clinic have an administration team. To create a patient claim, you can begin from two main areas; The Patient’s Profile or from their Appointment.

Learn the steps to to creating a patient claim in the following guide:

Creating a Patient Claim

Practice Drill 🏈

Let’s try out entering patient insurance information.

Instructions:

  • Ryan Anderson is ready for his appointment at the Demo Clinic. He is seeing the clinic for low back pain.
  • Ryan let you know he has insurance coverage available with Manulife and has handed you his Manulife card. The card has a Policy #37895 and ID#10.
  • Navigate over to Ryan’s profile and head into the Billing tab.
  • Next, click into the Claims tab.
  • Use the New Claim button in blue to save Ryan’s Manulife claim information.

Touchdown! 📣

Booking an Insured Visit

Once you’ve created and saved a patient claim, you can start insuring your patient’s visit(s). The following guide provides a great overview of our recommended work flow for booking an insured visit:

Booking an Insured Visit

Managing the Insurer Invoice

We have many Jane users working with online portals to bill insurance companies directly for their client’s visits.

This might be Medavie Blue Cross, Pacific Blue Cross, Telus E-Claims (including WSIB), HCAI etc.

If you are billing to the portal immediately, you are able to click the blue insurer name at the top of the appointment panel to open the Claim Management Screen:

From here you can launch the portal using the shortcut button and you can see all the info you would need to submit through the portal on a single screen. Hooray!

There are also some great tips in the following guides that will help with managing claim submissions:

Working with Claim Submissions (Online Insurer Portal)

Working with Paper Insurer Invoices

💡Jane Tip: If you haven’t experienced working with two screens you might fall in love once you try it. Most computers have a second port you can just plug another monitor in. It’s glorious and every administrator’s dream.

USA - Insurance Billing

With our new US insurance features, Jane allows you to create Superbills, generate EDI files for Office Ally claim submission, enter EOB’s, handle write-offs, and generate CMS-1500 forms. To submit and manage claims, there are a couple of things that first need to be set up in your Jane account. The video below will walk you through the full workflow of insurance billing, and shows how all the pieces come together once implemented at your clinic.

Note: The set up of insurance will need to be completed by a member of your team with Full Access.

Let’s review the most common insurance billing work flows:

Creating Patient Claims

When you’re ready to start saving your patients’ insurance information, we call this ‘creating patient claims’.

This step may be completed by a front desk staff member, should your clinic have an administration team. To create a patient claim, you can begin from two main areas; The Patient’s Profile or from their Appointment.

Learn the steps to to creating a patient claim in the following guide:

Creating a Patient Claim

Practice Drill 🏈

Let’s try out entering patient insurance information.

Instructions:

  • Ryan Anderson is ready for his appointment at the Demo Clinic. He is seeing the clinic for low back pain.
  • Ryan let you know he has insurance coverage available with Manulife and has handed you his Manulife card. The card ID number is #3789579.
  • Navigate over to Ryan’s profile and head into the Billing tab.
  • Next, click into the Claims tab.
  • Use the New Claim button in blue to save Ryan’s Manulife claim information.

Touchdown! 📣

Adding Billing Codes & Booking an Insured Visit

Once you’ve created and saved a patient claim, you can start insuring your patient’s visit(s).

First up, let’s review how to add fee/diagnosis codes to a visit for insurance billing or superbill creation.

Let’s say that you have just finished treating your patient, and they are now ready to check out. As a provider, you’ll want to add in the CPT and Diagnosis codes that apply to the patient’s visit. CPT & Diagnosis codes can be added to the Insurance Info section of the appointment by searching and selecting your desired codes.

This information can be entered from your Day view while charting by clicking on the appointment a second time, and opening the Insurance Info tab:

You can start by searching for the CPT code..

Once you have added in the CPT code(s), you can add in the diagnosis code(s) to each CPT code added to the visit.

Once the diagnosis codes are added to the appointment, you can either generate a superbill if the patient is a Cash patient, or add a claim to the visit if the patient has coverage.

More information on generating superbills in Jane can be found in the “Superbills” section below.

To add in a claim to insure the visit, you can press the “Add” button in the Insurance Info section to add primary coverage to the visit.

Once the visit is insured, you’ll be able to accept payment if the patient has any responsibility!

To walk through the steps of adding a claim and entering patient responsibility, check out the guide linked below. There are also some pro tips (i.e. how to copy a previous visit’s insurance info) in this guide that will help you down the road:

Adding Billing Codes & Insuring a Patient Visit

Superbills

You can create a superbill in Jane for any patients who would like to submit the document for insurance reimbursement (so you don’t have to, phew!).

You can generate a superbill for any appointment (paid or unpaid) after you’ve added CPT/billing codes. As a reminder, you can add billing codes to the Insurance Info section of an appointment from the Schedule.

Once you have added all of your billing and diagnosis codes to your patient’s visit, you can either Print, Generate a PDF, or Email a superbill to your patient.

Learn more here: Creating Superbills

Insurance Account Set Up

To walk through the insurance set up process step-by-step, a great way to start is by watching the videos linked below:

Getting Started With US Insurance

All done? Nothing can stop you now! Time to celebrate in Lesson 8.

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