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🇨🇦 Canadian Insurance Mini-Course

Welcome to Jane’s Canadian Insurance Mini-Course.

You may be here because you want to give Jane’s insurance a whirl, and you’re wondering if it is worth it. Or, maybe you’ve had patients inquiring about direct billing, and you’re ready to dip your toes in the water to see what it’s all about. Either way, we’re so happy you’re here.

Within this Insurance mini-course, we’ll be covering the essentials of Jane’s insurance features. So, no commitment required, but a fun way to see some insurance essentials in action.

By the time you’re done with this course, you’ll have the confidence you need to dive into the world of insurance — a valuable skill to grow your business, save time, and stay organized.

Within this course, we’ll use our Demo Clinic as a simulated user experience to submit a claim to Telus eClaims. Together, we’ll learn the following essential steps using Jane’s insurance features:

If you’re operating in a different country, we are working on three additional Insurance Mini-courses. Stay tuned!

  • 🇺🇸 U.S Insurance Mini-Course
  • 🇬🇧 UK Insurance Mini-Course
  • 🇦🇺 Australia Insurance Mini-Course

Course Preparation

💡Head on over to Jane’s Demo Clinic to practice as you learn (demo.janeapp.com). The username is owner, and you can find the login password by heading to the Jane Community Group on Facebook and clicking the ‘Featured’ tab. We update that every week. If you’re having any trouble, you can also request the password by email ([email protected]).

It’s 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? Let’s dive in!



Step 1: Creating a Patient Insurance Policy

Before insuring a visit, the first step is to add the patient’s insurance information into Jane. We call this ‘creating patient policies’. You can create a new Insurance Policy from two main areas; The Patient’s Profile or from their Appointment.

Practice Drill 🏈

Let’s try out entering patient insurance information within the Patient’s Profile.

Instructions:

  • Ryan Anderson has called into the Demo Clinic to ask you if there is Direct Billing to Canada Life. He’s in luck, as you’ve just integrated with Telus eClaims (this part is already done for you in the Demo Clinic.) 😉
  • Over the phone, you ask him for his Policy # and ID # so that you can add it to his Patient Profile.
  • Click “Patients” 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 “Patient Relationships to Insured” select Self in the dropdown menu.
  • Last but not least, hit save!

Touchdown! 📣

Answer Key 🔑



Step 2: Adding a Patient Insurance Policy to a Visit

When booking a patient in for a visit, Jane will ask if you’d like to add a related policy to the appointment. Jane makes it quick and easy for you to add a claim to a patient’s visit. Jane will remember the policy that was added from the patient’s previous visit(s), as well as any new policies that you have saved for this patient in their profile.

Practice Drill 🏈

Let’s 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 Swift’s 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 “Book”.

Touchdown! 📣

Answer Key 🔑



Step 3: Adding a Billing Code to a Visit

Before direct billing to an insurer through Jane’s direct billing integration with TELUS eClaims, you’ll 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 you’ll only see billing codes that relate to the treatment under a specific discipline.

Practice Drill 🏈

Now that the appointment is booked, let’s 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 you’re 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.

Touchdown! 📣

PRO TIP: 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.

Answer Key 🔑



Step 4: Eligibility Check

Before a patient’s appointment, you will be able to preview their coverage by submitting an Eligibility Check (referred to as a ‘predetermination request’ in the TELUS eClaims portal).

💡 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, you’ll see a response come through in a few seconds. You’ll also be able to see how much the insurer will be covering and be able to print the Explanation of Benefits form.

Practice Drill 🏈

You’ve booked Ryan Anderson’s appointment, selected his policy, added in his unique billing code, and now you’re in the home stretch! You’re ready to do an eligibility check.

Instructions

  • Ryan Anderson is coming in for his appointment today, and you’ve made sure his appointment is still in the “unarrived” state.
  • Scroll down within his appointment panel to the Insurance section, and let’s go ahead and click the “Check Eligibility” button.
  • You’ll now be brought to the Claim Preview window, where you can browse Ryan’s coverage to verify that all the information is correct. 👀✅
  • At the bottom of this page, click ‘select an option’ from the Where was this service rendered question and select “In-person at this location” from the dropdown menu.
  • Then, you’re ready to click the “Check Eligibility for 1 Claim” button.
  • Jane then communicates with TELUS and the insurer in real-time. Feel free to take a look at the information available to you. 😍
  • Close all windows, or click the X in the top right-hand corner

Touchdown! 📣

Answer Key 🔑



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, you’ll 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.

💡Note: 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. It’s as simple as that!

💡If 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.

Practice Drill 🏈

Ryan Anderson has finished up his appointment. It’s time to submit the claim and collect payment, if necessary.

Instructions:

  • You’ll first need to mark the appointment as Arrived.
  • Then, click the “Submit” button within the claim in the Insurance Info section. Scroll down to the bottom of the Submit Claims window, and answer the “Where was the service rendered?” question. Select “in person at the patient’s location” if it hasn’t 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.
  • You’ve now successfully submitted a claim from your Jane account directly to TELUS eClaims.
  • Curious to see Ryan’s updated insurance invoice? Head on over to the Patients tab > Search Ryan Anderson > and Click Billing within this profile. Jane’s updated the invoice status for you. ❤️

Touchdown! 📣

Answer Key 🔑



Step 6: Receiving a payment and applying it to insurance invoices

💡 Depending on the type of insurance you’re billing to, you’ll have the option to manually record a payment, or have it automatically recorded in Jane. In this example, let’s assume you’ve received a cheque in the mail and that you’ll 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. ✨

Practice Drill 🏈

Instructions:

  • You’ve just checked your clinic bank account, and Manulife has submitted a deposit of $350.00. It’s 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 “cheque” may not have been manually added yet), and enter $350.00 into the 💲Amount field.
  • Select the blue Apply button to apply payment to multiple outstanding insurance invoices.
  • Once you’ve applied the full $350.00 to multiple invoices, you’re all done!

Touchdown! 📣

Answer Key 🔑


Step 7: Time to celebrate!

Wahoo! You did it, and we’re so proud of you.🥇

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:

  1. ✅ Creating a Patient’s Insurance Policy;
  2. ✅ Adding a claim to a patient’s policy;
  3. ✅ Selecting a unique Billing Code;
  4. ✅ Running an Eligibility Check ;
  5. ✅ Submitting a Claim; and
  6. ✅ Managing Claim Payouts in Jane.

Ready to Get Started?

Whether you’re new to Jane or an existing Jane clinic, you’ll need access to Jane’s Insurance Features to direct bill and manage your claims to 3rd parties.

💡 For existing clinics, you may already have access if you’ve been grandfathered into an older plan. If so - no need to sign up for the Insurance Plan. You’re good to go!

Here’s 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].