💡Jane tip: We recommend heading over to Jane’s Demo Clinic to practice as you learn! Contact us to request the password or check out the Facebook community group where the password is posted each week.

Welcome back! In this chapter, we’ll guide you through the essentials of insurance billing in Jane for US-based clinics. Whether you’re starting fresh or moving over from another platform, this lesson will walk you through how to set things up and begin submitting claims.

If you’re coming from a different system, you might be able to import your existing insurance info. Here’s how to do that.

Note: These features are available to US clinics with the Insurance Billing add-on.

📄 Billing community

Did you know we have a US Billing Community? If you’re a Jane customer with insurance questions, curious about workflows, or just looking for support, we’d love to have you there. 💙

Where to begin

No matter which clearinghouse you use, your first step is to enable insurance features in Jane.

Jane’s built-in clearinghouse partner is Claim.MD, and using it provides the smoothest experience. If you haven’t connected with Claim.MD yet, this guide will help you get started.

Want a quick overview of how Jane and Claim.MD work together? Watch this video to see the full process in action.

Prefer a different clearinghouse? No problem. Jane lets you create EDI files for manual submissions. For cash-focused clinics, Jane can also generate Superbills. Here’s how that works.

Within Jane, you’ll see the words “insurer,” “policy,” and “claims” sprinkled in a few different areas. So, you may be wondering, ‘What is the difference between an Insurer, a Policy and a Claim?’. Let’s take a look:

• Insurer: Any insurance company that your clinic is set up to submit claims to. Your clinic can set up multiple insurers in Jane. Each insurer has their own rules and standards for how they like to receive claims. Clinics must follow these rules to be paid back properly.
• Policy: A patient’s agreement with their insurance company. In Jane, the policy is added for each patient with their individual policy, group, or plan numbers and details.
• Claim: A request for payment from a visit by clinic to an insurer. Each claim includes the policy details and specific information about the visit.

A quick overview of the process

Managing insurance in Jane involves two main stages: setup and then submitting claims. Here’s what it looks like:

Step 1: Initial setup

1. Add your insurance providers
2. Set rates for your Billing Codes
3. Confirm billing details for your clinic and team

Step 2: Submitting claims

1. Enter insurance details for each patient
2. Add the relevant Billing and diagnosis codes
3. Apply Billing codes and claims to a visit
4. Submit the claim using CMS1500 forms or EDI files
5. Record payments and Explanation of Benefits (EOBs) from insurers

Dive deeper with insurance training

Now that you know the basic steps, it’s time to dig into the details. Since insurance billing can be complex, we’ve created a separate training course to help you with insurance. We highly recommend completing it for both practitioners and administrative staff.

➡️ Start the US Insurance Training course.

If you’re a Billing Specialist, don’t miss our more in-depth training focused on Jane’s clearinghouse tools. Explore the advanced course here.

US insurance helpful resources

Jane includes a number of helpful tools to support your billing workflow beyond just the simple submission and payment workflow.

Here are some great next reads on how to make the most of your Insurance add-on:

• Adding CPT & Diagnosis codes to Charts
• Rebooking clients with the same Insurance info
• Adding Secondary Claims in Jane
• What’s an ERA in Insurance Billing?
• Insurance claims & the CMS1500
• Billing unlisted CPT Codes to Insurance
• Collect Insurance information on Intake Forms
• Billing Insurance claims for Telehealth Appointments

Great work! Head on to the next chapter to wrap up Jane for clinic admins.