To enter the insurance companies you deal with, select from the Back Office tab the Insurance Company and Plans button.
This button will open the Insurance manager screen from which you can enter and manage your various Insurance companies and their plans.
Select the New Insurance Company button to enter a new Insurance company record or policy.
The Insurance Company Record contains several tabs:
The Insurance Company Record contains several tabs. To create a valid insurance record you must complete the General Information Tab and the Insurance Policy tab. You must have at a minimum one (1) policy for each insurance company created. Some companies such as Blue Cross/Blue Shield may have several insurance policies that covers all of your patients. You can enter each policy in the policy tab by clicking the + button to add a new policy.
General Information: This is the demographic information for the Insurance Company. All items in yellow represent the minimum required field to be completed for Filopto to be able to create a valid Insurance claim. The other items are optional, but may be mandatory if the insurance company you are creating requires the fields to be activated. (Note: the Insurance Claim Creation Settings if set to "yes" will allow Filopto to do a validation of your claim, reducing possible errors. If set to "no" no claim scrubbing is performed.)
Insurance Policies: This tab contains the various Insurance Policies issued by this insurance company. Once the Insurance Policies are created they can then be used in the patient file to identify the policy the patient has and is also used at invoice time to create the claim record for the invoice. ( Please note that the tab also contains the option "Accept Assignment" if not selected the refund will be sent to the Patient. When selected the refund is sent to the provider.
The Insurance Policies tab also contains the Insurance Eligibility and Billing Rules tabs which permits users to define for a particular policy how Filopto calculates a claim. This advanced option can auto-create and apply the proper amounts to both the patient and Insurance portions of an invoice and claim.
IMPORTANT: Only once an insurance company and associated insurance policies are create can Filopto create a claim . No claim can be create by Filopto if the insurance company information or insurance policy information is missing or incomplete. This information is the base of a claim and used in conjunction with the Patient Insurance information and Invoice information to create a claim. Once a policy exist the field Status for the Insurance company can be set to Active. If no insurance policy exist for the Insurance Company an error will be generated when trying to set the status to active. |
