Setting Coverage Details and Benefits by Category on an Insurance Plan

Related Training

Managing Procedures and Fees Recorded Class

To set up coverage details and benefits by category on an insurance plan:

  1. Click your user name in the upper-right corner of the window. A list is displayed.

  1. Click Administration, if you have user permission.

  2. On the Administration tab, select Insurance > Plans. The Insurance Plans window is displayed.

  1. In the Coverage column, click Add or View for the plan. The Allowance Table Summary for the plan is displayed.

  1. Click Edit Allowance Table Details for this Plan. The Allowance Table is displayed.

  1. Under Actions, from the Category drop-down list, select a category. The Allowance Table for the procedures in that category are displayed.

  1. Click Adjust # Procedures. The Adjust Coverage Rules window is displayed.

  1. Select the items you want to adjust and then make the adjustment:

  2. Covered—Select Yes or No.

  3. Applies To Deductible—Select Yes or No.

  4. Copay Amount—Enter a dollar amount.

  5. Coverage Percentage—Enter a percentage.

  1. Click Apply.

  2. Click Save Changes.

 

Related Topics

Adding New Insurance Payers

Editing Insurance Payers

Adding New Insurance Plans

Editing Insurance Plans

Importing Coverage Details to an Insurance Plan

Setting Up Insurance Claim Processing

Managing Insurance Claims

Canceling and Resubmitting Insurance Claims

Submitting Secondary and Other Claims

Using ICD-10 Medical Diagnosis Codes and Submitting Medical Claims

Using CPT Codes for Medical Billing

Viewing Insurance Claims Statistics

Processing Unbilled Procedures

Printing Insurance Claims

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