Updating insurance plan information

You can update the information for an insurance plan attached to an insurance carrier that was added to your organization's database. Any changes made to a plan's information affects all patients covered by that plan.

To update an insurance plan

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

   Tip: To help you locate an insurance carrier quickly, enter part of a carrier's name, plan/employer, or group number in the search field to filter the carrier list.

   

   The options to edit the insurance carrier display.

   

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

   

   Tip: To help you locate a plan quickly, enter part of the plan/employer name or group number in the search field to filter the plan list.

   The options for editing the insurance plan display.

   

3. Change the plan information, such as the name or address, as necessary.

   Set up the following options:

   • Plan/Employer Name - The name of the insurance plan.

   • Group # - The group plan number.

   • Address - The address where claims for the insurance plan are mailed.

     Note: ZIP Codes must be nine digits.

   • Phone - The insurance plan administrator's contact phone number and extension (if applicable).

   • Fax Number - The fax number of the insurance plan administrator.

   • Contact - The name of the insurance plan administrator.

   • Email - The insurance plan administrator's email address.

   • Benefit Renewal Month - The month that the insurance plan's benefits reset.

     Note: If you select a month that has not passed yet, it takes effect in that month of this year. If you select a month that has already passed, it takes effect that month next year.

   • Source of Payment - The type of insurance company that will remit payment: CHAMPUS, Blue Cross/Blue Shield, Commercial Insurance, Medicare Part B, or Medicaid.

     Note: Patients whose insurance plans have "Medicaid" as the Source of Payment will not receive billing statements, as it is illegal in many states to send billing statements to Medicaid patients.

   • Type - The plan covers dental or medical procedures.

   • PPO Contracted Fee Schedule - (Use for PPO plans only.) The schedule of allowed charges for the insurance plan. The selected fee schedule will be used to determine a patient's portion and the recommended write-off.

     Important: For each provider (and each location that is set up as a billing provider for claims) who participates with this insurance plan, in that provider's user account (or that location's settings), you must select this carrier in the Contracted With section.

   • CAP Plan Fees - (Use for capitation plans only.) The selected fee schedule will be used to determine a patient's co-pay and the recommended write-off.

   • Coverage Tables - The coverage table for the plan. You can change the default deductible type and coverage percentage each procedure code range in the coverage table. Access to this window is available only if a Plan/Employer Name has been entered.

     Note: You can also add exceptions, but currently, only the "not covered" exception in coverage tables is used by Ascend Academic to automatically calculate insurance estimates.

   • Benefits - The deductibles and benefits for the plan. You can type the required deductible amounts for each deductible type and type the maximum benefits allowed. Access to this window is available only if a Plan/Employer Name, Address, City, State, and ZIP Code have been entered.

     

   • Note - A note that is specific to this insurance plan. You can enter text, such as information from an EOB or other document from the insurance carrier. Also, you can insert a date if needed. The note is accessible from all patient records that have this insurance plan attached.

4. ClickTap Save.