Jane University: Practitioner Training
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¨
Lesson 7: Insurance & Billing to a 3rd-Party
In our 7th and final lesson, weâre diving into the wonderful world of insurance billing! Jane helps your clinic manage insurance claims and allows you to send invoices to 3rd-party payers.
Note: The features covered in this chapter are only available to clinics on our Insurance Plan.
Managing insurance claims can work a bit differently depending on where you are located. Weâve divided this final chapter by location, so if you are one of our lovely US clinics, skip on down to the US Billing section to start learning :)
Insurance & Billing to a 3rd-Party
Jane helps you submit and manage insurance policies in a few ways: directly through Jane with one of our Insurance integrations, by paper or through an online portal. To insure visits, there are a couple of things that first need to be set up in your Jane account. The video below will walk you through the full workflow of insurance billing, and shows how all the pieces come together once implemented at your clinic.
Note: The set up of insurance will need to be completed by a member of your team with Full Access.
Please note that the âclaimsâ tab and button within the billing section of the patientâs profile are now referred to as âInsurance Policiesâ.
You may be wondering, what is the difference between a Policy and a Claim?
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Insurance Policy/Policy describes the thing a patient has purchased from an insurance company or any third-party coverage the patient has (i.e. provided by their employer, govât, etc.). An insurance policy can cover multiple purchases - or can have multiple claims.
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A Claim refers to each time you submit something against an insurance policy - itâs the thing you submit to the patientâs insurance. If you add an insurance policy to a visit, you create a claim under that policy. A claim can only have/come from one insurance policy.
Letâs review the workflows that are most common for front-desk staff members:
Creating a Patient Insurance Policy
When youâre ready to start saving your patientsâ insurance information, we call this âcreating patient policiesâ.
You can create a new Insurance Policy from two main areas; The Patientâs Profile or from their Appointment.
Learn how to add a new Insurance Policy in the following guide:
Creating a Patient Insurance Policy
Practice Drill đ
Letâs try out entering patient insurance information.
Instructions:
- Ryan Anderson is ready for his appointment at the Demo Clinic. He is seeing the clinic for low back pain.
- Ryan let you know he has insurance coverage available with Manulife and has handed you his Manulife card. The card has a Policy #37895 and ID#10.
- Navigate over to Ryanâs profile and head into the Billing tab.
- Next, click into the Insurance Policies tab.
- Use the New Insurance Policy button in blue to save Ryanâs Manulife policy information.
Touchdown! đŁ
Booking an Insured Visit
Once youâve created and saved a patient policy, you can start insuring your patientâs visit(s). The following guide provides a great overview of our recommended workflow for booking an insured visit:
Managing the Insurer Invoice
There are two main ways to process insurance through Jane - using an Insurance integration or through a 3rd party portal. To learn more about getting setup with Insurance integrations, check out the Canadian Insurance Integrations Hub. We also have many Jane users working with 3rd party online portals to bill insurance companies directly for their clientâs visits.
If you are billing to the portal immediately, you are able to click the blue insurer name at the top of the appointment panel to open the Claim Management Screen:
From here you can launch the portal using the shortcut button and you can see all the info you would need to submit through the portal on a single screen. Hooray!
There are also some great tips in the following guides that will help with managing claim submissions:
Working with Claim Submissions (Online Insurer Portal)
Working with Paper Insurer Invoices
đĄJane Tip: If you havenât experienced working with two screens you might fall in love once you try it. Most computers have a second port you can just plug another monitor in. Itâs glorious and every administratorâs dream.
USA - Insurance Billing & Cash Visits
With our integrated insurance features, we provide clinics with the tools needed to run an insurance-based practice. These include the ability to submit claims, view claim responses, manage rejections, and post remittances all in your account through our integration with Claim.MD.
Weâve been making some updates to make insurance billing simpler. Check out whatâs new and see how our Claim.MD integration can help you manage your entire revenue cycle in Jane.
If youâre using another Clearinghouse such as Office Ally, Trizetto or Availity: you can generate EDI files for submission, and upload ERAs into Jane for speedy remittance posting â but for the most integrated workflow, we recommend submitting through our Claim.MD integration.
To submit and manage claims, there are a couple of things that first need to be set up in your Jane account. Weâve put together a separate series of training guides titled US Insurance Billing Training to delve into the intricacies of how US Insurance works in Jane and the workflows you can use to stay on top of your claims.
US Insurance Account Set Up
To get started with the insurance set up process step-by-step, a great way to begin is by following the link below to our first entry into the Us Insurance Set Up:
Cash-Based Visits: Generating Superbills
Cash-Based clinics, we have you sorted, too! You can create a superbill in Jane for any patients who would like to submit the document for insurance reimbursement (so you donât have to, phew!).
You can generate a superbill for an appointment after youâve added billing codes.
Once you have added all of your billing and diagnosis codes to your patientâs visit, you can either Print, Generate a PDF, or Email a superbill to your patient.
Superbills with Packages
If you provide superbills for patients who submit their receipts to insurance and they are redeeming Packages, then we suggest creating Packages that are âpay as you goâ so the patient is charged each visit. Packages set up with an upfront cost and $0 per appointment will result in a superbill receipt that shows the patient paid $0, this is because no money exchanged hands at the time of the appointment.
We put together a quick video to go over the setup requirements. As a quick summary, the package will be set up as a âpay-as-you-goâ offer, but an initial upfront payment is collected and stored on the clientâs file as a credit. This payment is then used to cover the discounted rate of all upcoming appointments.
Already Set Up?
If your account is already set up for receiving and submitting US Insurance thatâs great! We can start entering our billing codes and patient policies into our appointments in just a couple of steps. Watch the video below for a quick overview of how to manage the CPT and ICD10 codes on your patientâs appointments in Jane.
đŁ Since filming the video below, you can now manage your CPT & ICD10 codes on your patientâs appointments directly in your chart note! To learn more about this, head on over to our guide on Adding CPT & Diagnosis Codes to Charts on the U.S. Insurance Plan.
To get a complete overview of the way US Insurance works in Jane you can head over to our Start Billing series to learn more:
Start Billing 1: Patient Insurance
All done? Nothing can stop you now! Time to celebrate in Lesson 8.
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