Welcome to Janeâs Canadian Insurance Mini-Course.
You may be here because you want to give Janeâs insurance a whirl, and youâre wondering if it is worth it. Or, maybe youâve had patients inquiring about direct billing, and youâre ready to dip your toes in the water to see what itâs all about. Either way, weâre so happy youâre here.
Within this Insurance mini-course, weâll be covering the essentials of Janeâs insurance features. So, no commitment required, but a fun way to see some insurance essentials in action.
By the time youâre done with this course, youâll have the confidence you need to dive into the world of insurance â a valuable skill to grow your business, save time, and stay organized.
Within this course, weâll use our Demo Clinic as a simulated user experience to submit a claim to Telus eClaims. Together, weâll learn the following essential steps using Janeâs insurance features:
- Step 1. Creating a patientâs insurance policy;
- Step 2. Adding a claim to a patientâs policy;
- Step 3. Selecting a unique billing code;
- Step 4. Running an eligibility check;
- Step 5. Submitting a claim; and
- Step 6. Managing claim payouts in Jane.
If youâre operating in a different country, we are working on three additional Insurance Mini-courses. Stay tuned!
- đşđ¸ U.S Insurance Mini-Course
- đŹđ§ UK Insurance Mini-Course
- đŚđş Australia Insurance Mini-Course
Course Preparation
đĄJane Tip: We recommend heading over to Janeâs Demo Clinic to practice as you learn! If youâre a current Jane user, you can find the login information by clicking the Need Help? Button in your account. This password is updated every Monday.
If you havenât signed up with Jane just yet, you can find the login password by heading to the Jane Community Group on Facebook and clicking the Featured tab. You can also request the password by emailing [email protected].
We always recommend using the demo clinic for testing and practice so that your own account stays nice and tidy. â¨
Itâs important that we work with the following details to successfully simulate a direct billing submission to Telus eClaims) in Jane:
- Login as the Demo Owner: owner
- Practitioner: Zoey Swift (Acupuncture)
- Location: The Village
- Insurance Provider: Canada Life (Telus eClaims)
- Patient: Ryan Anderson
Are you ready? Letâs dive in!
Step 1: Creating a Patient Insurance Policy
Before insuring a visit, the first step is to add the patientâs insurance information into Jane. We call this âcreating patient policiesâ. You can create a new Insurance Policy from two main areas; The Patientâs Profile or from their Appointment.
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Letâs try out entering patient insurance information within the Patientâs Profile.
Instructions:
- Ryan Anderson has called into the Demo Clinic to ask you if there is Direct Billing to Canada Life. Heâs in luck, as youâve just integrated with Telus eClaims (this part is already done for you in the Demo Clinic.) đ
- Over the phone, you ask him for his Policy # and ID # so that you can add it to his Patient Profile.
- Click âPatientsâ in the top blue bar, type in Ryan Anderson, select Billing > Insurance Policies > New Insurance Policies
- Then, select Canada Life from the list of insurers.
- Enter Lower Back Pain in the Name field (this is for internal use). Although not required, this can be a handy field to fill in for reference in the future.
- Ryan lets you know his Policy #37895 and ID#10, **so you can enter these in too.
- Under âPatient Relationships to Insuredâ select Self in the dropdown menu.
- Last but not least, hit save!
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Step 2: Adding a Patient Insurance Policy to a Visit
When booking a patient in for a visit, Jane will ask if youâd like to add a related policy to the appointment. Jane makes it quick and easy for you to add a claim to a patientâs visit. Jane will remember the policy that was added from the patientâs previous visit(s), as well as any new policies that you have saved for this patient in their profile.
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Letâs see how simple it is to add a policy to a patient visit.
Instructions:
- Ryan Anderson has decided to drop into the clinic. He asks if there are any availabilities with Zoey Swift today at The Village location for an Initial Acupuncture Visit.
- Navigate over to the Schedule and click Zoey Swiftâs name within your staff list. Then, click anywhere within her schedule to open up the appointment panel. Enter in Ryan Anderson, and select Initial Acupuncture visit within the treatment dropdown menu.
- Choose Policy #37895 from the list of options in the appointment panel. Then click âBookâ.
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Step 3: Adding a Billing Code to a Visit
Before direct billing to an insurer through Janeâs direct billing integration with TELUS eClaims, youâll also need to add a specific billing code to the appointment. When adding a billing code to the claim, Jane has made it really easy for you where youâll only see billing codes that relate to the treatment under a specific discipline. â¨
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Now that the appointment is booked, letâs add a billing code.
Instructions:
- Within the appointment panel, scroll down to the Insurance Info section.
- Select the billing code that matches the type of appointment and service youâre billing for. In this case, select billing code: 2.ZZ.02 - Initial Visit Assessment
- The necessary TELUS eClaims billing codes will have been pre-loaded into Jane for you but you can always review the available billing codes in your account. Head on over to Settings > Billing Codes to view these.
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PRO TIP:Â Not sure what billing code you need to use? Hit the space bar on your keyboard while in the billing code field and you can browse the selection of codes applicable to that appointment.
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Step 4: Eligibility Check
Before a patientâs appointment, you will be able to preview their coverage by submitting an Eligibility Check (referred to as a âpredetermination requestâ in the TELUS eClaims portal).
đĄ It is important to remember that an eligibility check is valid only for services rendered on the same day the check was performed. This means that an eligibility check done a day or more in advance of the actual appointment may not accurately reflect coverage amounts at the time of service.
An eligibility check relates only to services that have not yet been rendered and is a way to see the amount that the insurer would pay.
Once the eligibility check occurs, youâll see a response come through in a few seconds. Youâll also be able to see how much the insurer will be covering and be able to print the Explanation of Benefits form.
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Youâve booked Ryan Andersonâs appointment, selected his policy, added in his unique billing code, and now youâre in the home stretch! Youâre ready to do an eligibility check.
Instructions
- Ryan Anderson is coming in for his appointment today, and youâve made sure his appointment is still in the âunarrivedâ state.
- Scroll down within his appointment panel to the Insurance section, and letâs go ahead and click the âCheck Eligibilityâ button.
- Youâll now be brought to the Claim Preview window, where you can browse Ryanâs coverage to verify that all the information is correct. đâ
- At the bottom of this page, click âselect an optionâ from the Where was this service rendered question and select âIn-person at this locationâ from the dropdown menu.
- Then, youâre ready to click the âCheck Eligibility for 1 Claimâ button.
- Jane then communicates with TELUS and the insurer in real-time. Feel free to take a look at the information available to you. đ
- Close all windows, or click the X in the top right-hand corner
Touchdown! đŁ
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Step 5: Submitting a Claim
Submitting a claim in Jane is incredibly simple. With just a few clicks, Jane communicates with the insurer in real-time. Right away, youâll see how much the insurer will be covering, and be able to print the Explanation of Benefits form.
The Explanation of Benefits (EOB) is a response generated by the insurer when it has fully processed the claim submission. This statement will provide the detailed results of the adjudication, including the amount payable by the insurer, if applicable.
đĄNote: If you do not print the EOB right away, you can always access it again at a later date by viewing the submission.
Depending on the amount the insurer will be paying, Jane will automatically adjust the invoice to pass any remaining balance off to the patient, and the insurer invoice will also be updated appropriately. Itâs as simple as that!
đĄIf your insurance payments are set to automatic, then once submitted, Jane will mark this claim as Approved within your Billing > Insurer Invoices > Canada Life tab.
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Ryan Anderson has finished up his appointment. Itâs time to submit the claim and collect payment, if necessary.
Instructions:
- Youâll first need to mark the appointment as Arrived.
- Then, click the âSubmitâ button within the claim in the Insurance Info section. Scroll down to the bottom of the Submit Claims window, and answer the âWhere was the service rendered?â question. Select âin person at the patientâs locationâ if it hasnât already been selected.
- If that all looks good, you can close that window using the X in the top right-hand corner and proceed with collecting any applicable patient payments using the Pay button in the Appointment panel.
- Youâve now successfully submitted a claim from your Jane account directly to TELUS eClaims.
- Curious to see Ryanâs updated insurance invoice? Head on over to the Patients tab > Search Ryan Anderson > and Click Billing within this profile. Janeâs updated the invoice status for you. â¤ď¸
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Step 6: Receiving a payment and applying it to insurance invoices
đĄ Depending on the type of insurance youâre billing to, youâll have the option to manually record a payment, or have it automatically recorded in Jane. In this example, letâs assume youâve received a cheque in the mail and that youâll be manually recording it in Jane.
Once you receive a payment from the insurer, you can reflect that the insurer invoice has been Paid in Jane. Within Jane, you can create a payment to be applied to a single invoice, or multiple invoices. Once complete, Jane will update the status of the insurance invoices within the associated patient profiles as well. This allows you to easily manage hundreds of claims with different statuses all from Jane. â¨
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Instructions:
- Youâve just checked your clinic bank account, and Manulife has submitted a deposit of $350.00. Itâs time to reflect these changes in Jane!
- Head on over to your Billing tab in the top blue bar, scroll down to Insurer Invoices on the left, and select Manulife.
- Next, click the New Payment button in the top right-hand corner.
- From here, you can select any payment method from the drown down menu (since âchequeâ may not have been manually added yet), and enter $350.00 into the đ˛Amount field.
- Select the blue Apply button to apply payment to multiple outstanding insurance invoices.
- Once youâve applied the full $350.00 to multiple invoices, youâre all done!
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Step 7: Time to celebrate!
Wahoo! You did it, and weâre so proud of you.đĽ
How does it feel to have these new skills under your belt?
We hope you feel confident when working through these six steps in the future:
- â Creating a Patientâs Insurance Policy;
- â Adding a claim to a patientâs policy;
- â Selecting a unique Billing Code;
- â Running an Eligibility Check ;
- â Submitting a Claim; and
- â Managing Claim Payouts in Jane.
Ready to Get Started?
Whether youâre new to Jane or an existing Jane clinic, youâll need access to Janeâs Insurance Features to direct bill and manage your claims to 3rd parties.
đĄ For existing clinics, you may already have access if youâve been grandfathered into an older plan. If so - no need to sign up for the Insurance Plan. Youâre good to go!
Hereâs how to upgrade from the Base Plan to the Insurance Plan.
If you have any questions or comments, we love hearing from you. Please reach out to our support team at [email protected].