Welcome back to the Jane US Insurance Billing training! If you haven’t already, complete the setup lessons first, starting with Insurance Setup 1: Adding Your Insurers.

This lesson is the third of nine in the US Insurance Billing training:

Billing Lesson	Status
Patient Insurance	🥳
Adding Billing Codes to a Visit	🥳
Managing Insurance and Patient Responsibility on a Visit	✍️
Claim Submission Folders	☐
Claim Submission	☐
Managing Rejections	☐
Posting Insurer Responses	☐
Resubmissions	☐
Accounts Receivable	☐

Now that you’ve added billing codes to the visit, you can insure it. In this lesson, you’ll add an insurance policy to the visit, enter the patient’s responsibility, and remove, view, or edit policies. The lesson also covers paid visits and secondary policies.

Instructions

Here’s how to insure a visit in Jane and manage the patient’s responsibility on it. Once you add a policy and Arrive the appointment, Jane generates an invoice for the insurer and the patient.

Adding an Insurance Policy to a Visit

1. Open the Appointment Panel and scroll down to the Insurance Info section.
2. Click Add next to Primary Policy.

3. Select the primary insurance policy from the list.

To create a policy for the patient instead, select Add New Policy. See our guide on Insurance Billing 1: Patient Insurance.

Entering Patient Responsibility

Use the Deductible, Co Pay, and Coinsurance fields to tell Jane how much of the cost of the visit the patient owes.

1. In the Insurance Info section, click the insurer’s name (in blue text) to open the patient responsibility details.

2. Enter the patient’s responsibility in the Deductible, Co Pay, or Coinsurance field, as described in the examples below.

Jane saves the amounts automatically. To record an insurer payment, click Pay.

🩵 Jane Tip: You can set default patient responsibility amounts in the patient’s insurance policy settings under Default Coverage Amounts. See our guide on Insurance Billing 1: Patient Insurance.

If you’ve added Allowed Amounts for your CPT codes in Settings > Billing Codes, Jane calculates the invoices from those Allowed Amounts, which gives you a more accurate patient responsibility estimate. If you haven’t, Jane calculates the invoices from the full Billed Amounts. See our guide on Insurance Setup 2: Assign Rates to Your CPT Codes.

Deductible Example

If a patient has a deductible, enter the known remaining deductible amount in the Deductible field. This tells Jane that insurance won’t pay anything toward the patient’s visits until that amount is reached, so Jane pushes the full Allowed Amount to the patient’s invoice.

For example, a patient named Ann has a $1,000 deductible at the beginning of the year. She comes in for an insured visit, and you bill a single code with a Billed Amount of $120 and an Allowed Amount of $75.

Because Ann’s deductible is higher than the Allowed Amount, Jane pushes the entire Allowed Amount down to the patient:

At Ann’s next visit, Jane reduces the deductible by the amount invoiced at the previous visit ($75 in this example):

📣 Heads up: Jane doesn’t communicate externally to check for up-to-date deductible information. If a patient has gone elsewhere for treatment, update the deductible in Jane manually.

Copay or Coinsurance Example

If the patient has a copay or coinsurance, enter the dollar amount in the Co Pay field or the percentage in the Coinsurance field for each visit. Jane pushes only that amount down to the patient:

Removing, Viewing, or Editing an Insurance Policy

If you added an insurance policy to a visit by mistake, or picked the wrong one, you can remove it:

1. Open the Appointment Panel or Purchase Screen.
2. Go to the Insurance Info area.
3. Click the drop-down arrow to the right of the policy name.
4. Select Remove Policy.

The same menu also lets you select View Policy or Edit Policy to see or change the policy information.

Adding Insurance Information to a Paid Visit

If you need to add billing codes or an insurance policy to a paid appointment, use the Allow Editing toggle to make your changes.

📣 Heads up: Editing a paid visit changes an invoice that has already been paid.

1. Open the Appointment Panel or Purchase Screen.
2. Scroll down to the Insurance Info section.
3. Toggle on Allow Editing.

4. Add the insurance information you need.
5. Click Update Invoices.

Jane shows the Update Invoices button once you’ve entered the updated information.

When you click Update Invoices, Jane re-applies the patient’s original payment behind the scenes. If a balance remains, Jane shows it as the amount owing on the patient’s account. If the original payment exceeds the amount of the regenerated invoice, Jane creates a credit on the patient’s profile.

Adding a Secondary Policy

1. Open the Appointment Panel and scroll down to the Insurance Info section.
2. Click Add next to Secondary Policy.
3. Select the secondary insurance policy from the list.

To create a policy for the patient instead, select Add New Policy. See our guide on Insurance Billing 1: Patient Insurance.

After you add a secondary policy, an Add Policy button appears below it. To add a tertiary policy, click Add Policy.

What to Expect

• Adding a policy: After you select a policy, the visit is insured, and Jane generates an invoice for the insurer and the patient once you Arrive the appointment. If you create a new policy, Jane returns you to the appointment with the policy added after you save it.
• Entering patient responsibility: Jane pushes the patient’s share down to the patient’s invoice. Once the visit is insured and the patient invoice is generated, you can accept payment if the patient has any time-of-service patient responsibility.
• Adding a secondary policy: The policy appears under Secondary Policy in the Insurance Info section.

Important Notes

• Each billing code has its own Allowed Amount field. Co Pay, Deductible, and Coinsurance are entered once for the policy.

Billing Secondary Insurance Claims

To learn more about billing secondary claims, or if your primary claim gets submitted to the secondary on your behalf (like Medicare), see our guide on Billing Secondary Insurance Claims.

Nice work! Next up, claim submission folders.

Related Guides

• Next lesson: Insurance Billing 4: Claim Submission Folders
• Training hub: US Insurance Billing Training Hub