Creating coverage table templates

Ascend Academic has two template types: Insurance Coverage, % and Patient Copayment, $. Insurance Coverage, % type displays templates that are based on insurance coverage percentages, and Patient Copayment, $ type displays template that are based on fixed patient copayments.

To create a coverage table template

1. On the Coverage Table Setup page, complete one of the following:

   • Create new - To create a brand new coverage table template, clicktap New Coverage Table.

     

   • Base on existing - To create a coverage table template based on an existing template, expand a template type and select the template that is similar to the one that you want to create.

     

   The options for adding or editing a coverage table template displays. The options that are available depend on whether you are creating a brand new template or creating one that is based on an existing template.

   New

   

   Based on Existing

   

2. Enter or change the name of the template in the Template name field. A coverage table template's name must be unique to the templates of the same type.

3. If creating a brand new template, select a template type from the Type drop-down list to specify whether the coverage should be based on a percentage or a fixed amount. If creating from an existing template, skip this step.

   Note: Once you save the template, you cannot change the type.

   

   If you selected Insurance Coverage, %, a blank list of code range displays. If you selected Patient Copayment, $, a blank list of procedure code displays.

4. Add, edit, and/or delete procedure code ranges as necessary.

   • For an Insurance Coverage, % type template:

     1. ClickTap Add Range to add a procedure code range or select an existing range to edit it.

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

        • Code Range - Enter 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 no 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 then clicktap somewhere else, the text of the modified range turns bold. Also, any ranges that overlap or that are invalid becomes highlighted in red, and you cannot save the changes to the coverage table until you fix the errors.

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

        • Deductible Type - The deductible type that applies to the procedures.

        • Coverage % - The percentage 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 to add or edit multiple code ranges.

     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 template will be deleted. However, you cannot delete all the ranges in the default template.

   • For a Patient Copayment, $ type template:

     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 necessary 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. However, you cannot delete all the codes in the default template.

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

6. Complete one of the following:

   • For an all new template, clicktap Create.

   • For a template based on another, clicktap Save As New Template.