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US Insurance Billing Additional Resources

  • ​Missing the Insurers Tab? Adding the Insurance add-on to the Practice or Thrive Plan

    Are you trying to set up your Insurers but the tab seems to missing? It sounds like you might not be signed up for Jane’s insurance add-on. Heads up — the insurance add-on can be added to the Practice or Thrive plans.

  • 🇺🇸 Integrated Claims with Claim.MD

    Billing with Jane just got better! Manage all of your day-to-day insurance billing right inside Jane when you connect your Claim.MD clearinghouse account.
  • 🇺🇸 Secondary Claims in Jane

    This guide walks through how you can manage patients that have secondary or supplemental insurance coverage - where the client has multiple insurance policies(i.e. primary and secondary insurance).

  • 🇺🇸 Billing Secondary Insurance Claims

    Learn how you can bill secondary claims in Jane as easily as you bill your primary claims!
  • 🇺🇸 What's an ERA in Insurance Billing?

    In the world of insurance billing, an ERA or Electronic Remittance Advice provides details about claim payments. Check out our comprehensive guide to learn more.
  • ERA Management Tool FAQ

    A paper or electronic transaction that includes adjudication information (who is paying for what) and payment information for one or more claims. A remittance includes a single payment amount - and parts of the payment amount are assigned to some but not necessarily all claims responses included ...

  • Posting Insurer Payments With Electronic Remittances (ERAs)

    Show me the money! In this guide, we’ll walk through how you can post insurer payments using our ERA Management Tool by uploading electronic remittances (ERAs) to Jane. If you still have questions, you can visit our fully-loaded FAQ guide which we’re continuing to grow as well.

  • CMS1500 Reference Sheet

    So you’ve generated your CMS1500 form in Jane. 🎉

  • Billing Under a Different Practitioner (Rendering Provider)

    Sometimes, you might book a patient into one practitioner’s schedule, but you need to bill the patient’s claim to insurance under a different practitioner or Rendering Provider (Box 31 on the CMS1500). You might run into this scenario at your clinic if you employ students, recent graduates who ar...

  • Billing Unlisted CPT Codes to Insurance

    Most services that you perform at your practice are represented by specific codes in the CPT code set. However, sometimes you might perform a treatment that isn’t represented in the CPT code set. This is usually only the case for newer or more unique services.

  • Cash Visits & Superbills

    💡Heads up — this guide contains some workflows that are only available on the Thrive plan, and some that require Jane’s insurance billing features. We’ll let you know which workflows these are throughout the guide.

  • Collect Insurance Information on Intake Forms From Your Clients 📸

    Jane offers a dedicated way for clients to upload photos of their insurance cards and provide their most basic insurance policy details in an intake form.

  • Courtesy Billing or Patient Pre-Pay (US)

    Courtesy Billing refers to the workflow where your patients pay at the time of service, and you as the provider submit a claim to insurance on their behalf. Patients then receive reimbursement from insurance directly. For some clinics, it’s the Goldilocks of workflows that’s hits on a sweet spot ...

  • ICD-10 Code Set Updates FAQ

    Every year, CMS updates the ICD-10 diagnosis code set. These yearly updates typically take effect on October 1st, and include additions of new billable codes, revisions of code descriptions, and the deletion of codes that are no longer valid or needed.

  • Insurance Claims & The CMS1500

    💡Heads up — while CMS1500 forms can be created on the Balance, Practice, or Thrive subscription plans, entering in insurance-specific information is only available with the insurance add-on on the Practice or Thrive Plan.

  • Creating & Managing Good Faith Estimates in Jane

    If you’d like to learn more about the No Surprises Act and Good Faith Estimates, you can check out this blog post.

  • Adding CPT & Diagnosis Codes to Charts (US)

    Jane’s goal is always to be helpful, and when it comes to documentation and insurance billing, that means being thorough, compliant, and efficient.

  • Setting a Place of Service Code

    Hey there friend! If you need help setting a Place of Service (POS) code for claims that you’re billing to insurance, or for superbills that you’re providing to your clients, then you’ve come to the right place.

  • How do I reconcile insurance claim reversals?

    Check out this guide to learn how to record and review these responses through Jane.

  • Posting Insurer Payments With Paper EOBs

    You have submitted your claims in Jane and a couple of weeks have gone by – now insurance companies are mailing you cheques along with paper EOBs. Not sure how to record these payments in Jane? Continue reading!

  • Superbills on the Base Plan

    💡Heads up — this guide is applicable for the Legacy Base Plan only.

  • Switching clearinghouses to Claim.MD

    Looking to switch clearinghouses but not sure where to start? Check out our step-by-step guide to switching from your current clearinghouse to Claim.MD.
  • 🇺🇸 Integrated Claims with Claim.MD - FAQs

    If you have questions about working with Claim.MD in Jane, you’ve come to the right place. Here, you’ll find answers to some of the most commonly asked questions about Integrated Claims with Claim.MD, along with some helpful troubleshooting tips.

  • Box 16

    If a claim is related to an injury that caused the patient to miss work, this box is used to indicate the date range where the patient was unable to work in their current occupation.

  • Box 24

    Skip to the box you’re looking for:.

  • Box 11

    This box is for the Insured’s Policy, Group, or FECA number (if applicable). Note that this is different than the patient’s Member/Subscriber ID.

  • Box 9

    The Last Name, First Name, and Middle Initial of the Insured (Policyholder) for the Patient’s Secondary Insurance Policy.

  • Box 17

    If the services rendered involved a Referring, Ordering, or Supervising provider, Box 17, Box 17a, and Box 17b are used to identify that additional provider.

  • Box 32

    This box holds the Name, Address, and Zip code of the location where the services were rendered.

  • Box 12

    This box contains the patient’s (or authorized person’s) signature. It is left blank if the patient does not authorize the release of their medical information to process the claim.

  • Box 13

    This box indicates whether or not the provider has obtained explicit permission from the Insured (Policyholder) that authorizes payment of medical benefits to the party accepting assignment.

  • Box 1

    Skip to the box you’re looking for:.

  • Box 10

    This box indicates whether the patient’s illness or injury is related to their employment or an accident. For example, by checking the box labelled Employment (current or previous), the submitter indicates that the condition is related to the patient’s job or workplace.

  • Box 15

    Box 15 is used to report another date (i.e. Last X-Ray) related to the patient’s condition. Similar to Box 14, this box includes a spot to enter a 3-digit qualifier to identify the date type being reported.

  • Box 21

    This area is used to list a maximum of 12 diagnosis codes that describe the patient’s condition. The diagnosis code listed on Line A is considered the primary or principal diagnosis. Each diagnosis code is linked to at least one procedure (these links - or ‘pointers’ - are reported in Box 24E.

  • Box 22

    This box is used to inform an Insurance company that the claim in question has been previously filed. This box has space for two pieces of information:

  • Box 29

    The amount that the patient and/or other payer has already paid towards the claim.

  • Box 28

    This box shows the Total Charge for all services rendered. It reflects the sum of the charges in Box 24F for all procedures on the claim.

  • Box 31

    The first part of this box contains the credentials and name/signature of the rendering provider. By including their name, the rendering provider certifies that the information in the claim is correct. The second part includes the date that the form was signed.

  • Box 3

    This box indicates the patient’s date of birth and legal sex.

  • Box 2

    Forgive us for this one, but in the pursuit of being thorough: this box includes the patient’s full name. It will be entered as Last Name, followed by First Name, and then Middle Initial (if applicable).

  • The Top Right Corner

    This area of the form holds the Legal Name and Full Address of the payer (Insurer) that is being billed. It indicates where the claim will be sent.

  • Box 4

    This box indicates the full name of the person who holds the Insurance Policy (also known as the Insured).

  • Box 5

    This box contains the patient’s full address and phone number.

  • Box 6

    This box indicates the patient’s relationship to the Insured (the Policyholder). For example, if the patient is the Policyholder (their Policy Member ID is reported in box 1a), then check ‘Self’.

  • Box 7

    This box indicates the address and phone number of the Insured (the Policyholder).

  • Box 14

    This box is used to display the date on which the patient’s current illness, injury, or pregnancy began. The qualifier in this box indicates the type of date being recorded.

  • Box 18

    If a patient is seeking treatment for a condition that resulted in a hospital admission— and the hospital admission and/or discharge dates are known to impact the payer’s adjudication process— then report the patient’s hospital Admission and/or Discharge dates.

  • Box 19

    This box is used to communicate additional information about the patient’s condition or the claim.

  • Box 20

    This box indicates whether or not the service was provided by an entity other than the billing provider. In Jane, ‘NO’ is always checked, and $0.00 is entered under the $ CHARGES section by default.

  • Box 23

    This box contains the Payer Assigned Number that authorizes the services being billed. If applicable, enter the authorization number assigned by the Insurer for the current date of service. This is only required if the Insurance Company requires pre-authorization for patient encounters.

  • Box 25

    This box is looking for the federal tax identification number and number type (either a Social Security Number or an Employer Identification Number). This is the tax identification number (TIN) for the entity to be paid for the submitted services (typically the billing provider).

  • Box 26

    This box contains the number that the provider (clinic) uses to identify the patient.

  • Box 27

    What this box is looking for varies by Insurance type and there doesn’t seem to be one clear definition - even for Medicare.

  • Box 33

    This box contains the Billing Provider’s name, address, and phone number. This information lets the Insurance company know where to direct payment.

  • How to Archive and Unarchive an Insurer

    Sometimes we create duplicates of insurers, or insurers that we only need to use for a short period so we’d like to “delete”, AKA archive, the insurer so we can clean up our active list of insurers.

  • Creating a Patient Insurance Policy (US)

    To add a patient’s insurance policy, you can begin from two main areas; The patient’s profile or from their Appointment.

  • Re-booking Clients with the Same Insurance Info

    If so, you can copy insurance information either when booking a patient visit or after the patient has booked to save yourself some time. This applies for both cash and insurance patients!

  • 🇺🇸 Eligibility Checks with Claim.MD

    Jane’s clearinghouse integration got a big improvement: Eligibility Checks with Claim.MD is officially available! All US customers with insurance features can now connect their Claim.MD account with Jane to make real-time eligibility checks.

  • Uploading an EDI File to Office Ally

    Once you have generated and downloaded some EDI files that are ready for submission, you’ll need to log in to your Office Ally account to upload the files. If you need a little refresher on that process, check out our guide on Creating an EDI File to Submit to a Clearinghouse.

  • Jane's Clearinghouse Integration 🇺🇸

    Looking to learn more about how to manage your day to day billing with Integrated Claims with Claim.MD? We’ve put together this guide to connect you with all the resources you might need for all things Claim.MD. Let’s dive in!

  • Creating and Setting Up Insurers (US)

    Note 📝: This is for accounts with the Insurance Add-on. If you don’t see the Insurers tab in your Settings, check out our guide doc on Adding the Insurance add-on.

  • Reordering Diagnosis Codes

    Have you been looking for our little ditty about setting a Primary Diagnosis codes, Ordering Diagnosis codes, or were you just browsing our lovely guide? Well either way I hope you enjoy the read.

  • Refreshed Insurance Workflows: Transitioning Your Insurance Appointments

    While working through these refreshments, you may have noticed that a few boxes and features have left Jane’s insurance billing altogether. Specifically, when working with an insured appointment, you’ll notice that Eligible Amount, Max Amount, Coinsurance as a $ amount, and Percent Coverage have ...

  • Billing Insurance Claims For Telehealth Appointments (US)

    💡Heads up — this guide contains some workflows that are only available with Insurance Billing. We’ll let you know which workflows these are throughout the guide.

  • Insurance Specific Reporting (US)

    They say knowledge is power and reports help keep you informed about how your practice is doing.

  • Submitting a Claim when Medicare is the Secondary Payer

    Ah, Medicare.

  • Delete an Insurer Payment

    This is an area where it’s important to understand the affects of deleting a payment on your reporting. Deleting a payment may seem like the easiest way to fix something, but while it may look right on the screen in front of you, the reports (especially the Compensation Report) will also be changed.

  • How to Attach Supporting Documents to Claims in Claim.MD

    Sometimes you’re required to submit insurance claims with supporting documentation, like patient chart notes. At this time, you can’t send chart notes with claims directly from Jane, but this can be managed in your Claim.MD portal.

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