Editing coverage tables

You can edit the coverage table that is attached to an insurance plan. A coverage table references which procedures a carrier covers and at what percentage. Along with deductibles and benefits, a coverage table allows for accurate insurance estimates.

To edit a coverage table

1. On the Insurance Carriers page, select an insurance carrier.

   The options for editing the insurance carrier display.

2. Under Plans/Employers, select an insurance plan.

   The options for editing the insurance plan display.

3. ClickTap Coverage Table.

   

   The Coverage Table window displays.

   

4. (Optional) If necessary, select a different option from the Type drop-down list to set to a different coverage table type.

   

   Notes: When you change the coverage table type, one of the following occurs:

   • If you change the type to Patient Copayment, $, the coverage table changes to the previous version of the patient copayment ($) type coverage table for this plan or, if this is the first time that you have changed the type, the default patient copayment ($) type coverage table.

   • If you change the type to Insurance Coverage, %, the coverage table changes to the previous version of the insurance coverage (%) type coverage table for this plan or, if this is the first time that you have changed the type, the default insurance coverage (%) type coverage table.

5. (Optional) If necessary, you can replace the coverage table with that of a template or another plan, or you can delete the coverage table to make a new one from scratch (not recommended).

6. Add, edit, and delete the procedure code ranges as necessary.

   • For an Insurance Coverage, % type table:

     1. Complete one of the following:

        • ClickTap Add Range to add a procedure code range.

        • Select an existing procedure code range to edit it.

     2. Set up the following options for that range as necessary:

        • Code Range - The ADA or custom procedure code range. These fields accept dashes (-), periods (.), numbers, and letters, and they can be up to 10 characters in length. Make sure there are not any overlaps and gaps in the sequence between the starting and ending codes in the range and between other ranges.

          You can include an alias procedure codes in a range by entering a period (.) in either text field. The Code Range text fields change to allow for entering suffixes. Enter a suffix in either or both suffix text field. If you need a period in either of the main code boxes (the text fields to the left of the suffix text fields), you must enter the period again in that text field.

          

          Note: When you change a range and clicktap somewhere else, the text of the range that you modified turns bold. Also, any ranges that overlap or that are invalid become highlighted in red, and you cannot save the changes to the coverage table until those errors are resolved.

        • Category - The procedure category for the procedures in the range.

        • Deductible Type - The type of deductible that the procedures in the range apply to.

        • Coverage % - The percent that the insurance carrier pays on covered charges (after any deductible, up to any allowed amount, and up to any maximum allowed benefit) for procedures in the range.

     3. Repeat Steps a - b for any other ranges you want to add or edit.

     4. To delete a range, clicktap the corresponding Remove icon, and clicktap Delete, when prompted.

        Important: If you are deleting the only range in the coverage table, the entire table will be deleted.

   • For a Patient Copayment, $ type table:

     1. Complete one of the following:

        • ClickTap Add Procedure to add a procedure code(s). From the Add Procedures window, select the check boxes of the procedure code(s) and clicktap Add Checked.

          Note: If you are adding procedure codes to a coverage table that already has procedure codes, the procedure codes are added at the top of the table, which might not be the correct order. When you save the template, the procedure codes will be listed in the correct order.

        

        • Select an existing procedure code range or newly-added procedure code to edit it.

     2. Set up the following options for that code as necessary:

        • Deductible Type - Select the type of deductible that applies to the procedure.

        • Copayment $ - Enter the specific amount the patients must pay for the procedure.

     3. Repeat Steps a - c for any other codes that you want to add or edit.

     4. To delete a range, clicktap the corresponding Remove icon, and clicktap Delete, when prompted.

        Important: If you are deleting the only code in the coverage table, the entire table will be deleted.

7. To add, edit, or delete exceptions to the coverage for specific procedures, clicktap Manage Exceptions.

8. Complete one of the following:

   • To apply the changes to the coverage table and to create a new coverage table template using the specified coverage options, clicktap Save As New Template. In the generated New Coverage Table Template window, enter a name for the template, and then clicktap Save.

     

   • To apply the changes to the coverage table, clicktap Save.

9. ClickTap Save or Cancel.