Patient Insurance Settings Updates

On the patient Billing Settings tab, users can now enter multiple instances of primary and secondary insurance policies as well as document tertiary and quaternary policies. Policies which have expired or are otherwise no longer in use can now be disabled instead of deleted. Some improvements were made to prior authorizations to support these new settings.

Patient Billing Settings

The patient Billing Settings tab has been significantly enhanced to support these new features. In prior versions of TherapyNotes, it was only possible to enter one instance of a primary or secondary insurance policy.  This meant that prior policy information needed to be removed before a new policy could be added. Therefore, if a biller needed to bill old dates of service, the current policy would need to be removed and the old policy needed to be added back in temporarily.

Billers can now add multiple insurance policies per priority (primary, secondary, tertiary, quaternary).  This enables billers to preemptively add a new insurance policy for a patient prior to the expiration of the old policy resulting in fewer billing errors. Users have the option of entering a coverage date range for each policy, so TherapyNotes will automatically indicate that a policy is expired once the coverage period ends.  As old policies expire, they will no longer be linked to new billing items that occur outside of the coverage period.  Billers have the option of disabling an insurance policy that has expired or is otherwise no longer needed.

Prior Authorizations

Prior authorizations are a part of insurance policies. To add or edit a prior authorization, billers must open the edit screen of the insurance policy to which the prior authorization is attached. If an insurance policy is disabled, all prior authorizations linked to that policy will also be disabled. The service code and insurance policy associated with the prior authorization must match the date of service in order for the prior authorization to be included on the claim.

Selecting Policies for Appointments

It is now easier to select or change an insurance policy for a service. When a new appointment is created, enabled policies with active coverage dates will automatically be selected for the appointment. When a patient has multiple insurance policies, the policy linked to the service date can be changed as long as the policy is active for that date of service.  Billers can select a different policy from the policy drop down menu within the Billing tab for the date of service. This applies to primary and secondary policies. Expired insurance policies will not appear as an option unless the date of service falls within the coverage period for the policy. Disabled policies will not appear as an option unless the policy was already assigned to the service before it was disabled. A warning message will be displayed if the selected policy is disabled and/or expired. This warning will not prevent the biller from being able to resubmit a claim or add insurance payments. 

Enabling and Disabling Payers

Additionally, with this update, billers will have the ability to disable payers that are no longer needed. Previously, it was possible to delete a payer completely. However, deleting a payer completely can become an issue if old dates of service need to be resubmitted, or old insurance payments need to be entered. Billers can still enter insurance payments from disabled payers for previously submitted claims. However, disabled payers can not be assigned to new dates of service or any new patient insurance policies. Disabled payers can be enabled again at any time. A payer can only be deleted if it has never been used for billing purposes.  In order to delete a payer, it first needs to be disabled.  

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