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Insurance Mode on Claims: Payable to Patient vs Payable to the Clinic (CA)

On every Jane account, the insurance billing default is set to Collect from Insurer. This means that you are expecting the insurance company to pay you (the clinic) rather than send money directly to the patient. However, you do have the option to switch a purchase on your account to Patient Pre-Pay.

If a purchase is set to Patient Pre-Pay, Jane will bill the patient your full appointment fee at the time of service. After accepting payment from your patient or client, you submit the claim to insurance on their behalf. This saves your patients and clients the hassle of having to submit the claim on their own.

NOTE📍: Sometimes you can submit a claim to an integrated insurer (i.e. Telus eClaims) with the insurance mode set to Collect from Insurer but the response comes back that it’s Payable to the Patient. This comes directly from the insurer and cannot be changed.

To change the insurance mode of an unpaid invoice, you can head over to the Patient or Client’s Profile, and then over to the Billing tab within their Profile. From there, you’ll want to click on the word View to the far right of the desired invoice line:

Next, you can scroll down to the Insurance section and then click on the cogwheel icon in the top right of the section:

A pop-up window will appear before the change is applied, letting you know the implications of updating the insurance mode. This change will update all the invoices. If there are any payments applied, they’ll be unapplied and hanging out as a credit either within the patient or client’s profile or under the Billing tab under Insurer Invoices with that specific insurer.

For any payments that were unapplied during this process, you can read more about how reapplying this payment would affect certain financial reports in Jane using our Working with Purchase, Invoice, Received At and Applied At Dates guide that has more detailed information (and a recorded video 🎥)

You can always adjust an invoice’s dates so that your reporting is accurate. See:

Lastly, even though the insurer will be paying the patient or client directly, you notice that within your Jane account the insurer invoice will still have an Unpaid status:

Jane loves checks and balances, so this is an indirect way of ensuring that the patient was actually paid for the visit. You’ll want to go ahead and mark this claim as Paid and Approved. It’s important to note that this does not count as income collected for the clinic.

To mark the claim as Paid and Approved, you’ll want to click on the black dropdownarrow and then select Pay & Approve Pre-Pay Invoice:

If you are looking to Courtesy Bill patients and you’re clinic is in the US, you’ll want to pop on over to our Courtesy Billing or Patient Pre-Pay guide that goes over how your clinic would accomplish this in more detail.

We hope this helps! As always, let us know if you have any questions on this, we’re happy to chat this through 😊

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