How to Add or Edit Coverage Details for an Insurance Plan

You can access an insurance plan's coverage details, or Allowance Tables, from The Coverage column in the Insurance Plans List. (Administration > Insurance > Plans). These tables define the covered percentage or amount patient insurance is expected to pay for defined categories and procedures. This information is used to estimate patient and insurance due amounts, and is reflected in the Patient Ledger and Billing Statements. 
Note: It is important to set up these tables correctly before entering charges. Updates to Allowance tables affect transactions going forward, but cannot correct past transactions. 

Note: You can access the this table for an individual plan by selecting View Allowance Table from the Update Insurance Plan window.

To add or edit coverage details for an insurance plan:

1. From the Administration tab, select Insurance > Plans. The Insurance Plans list is displayed.
2. Use the filters to refine the list as needed; click column headings to sort the list.
3. In the Coverage column for each plan, select Add or View.
   Note: If you click View, a Table Summary is displayed. You can then click Edit Allowance Table Details for this Plan to make changes.
   The Plan Name - Allowance Table window is displayed.

4. Under Actions, select Import Values.

5. In the Import Table Values from field, select Office Fee Schedule or Existing Allowance Table.

6. Click Import Values.
   Important:  ALL procedures must have a fee associated with them before you import the table.

7. For Office Fee Schedule, select Overwrite All or Fill in Blanks.

8. For Existing Allowance Table, select Plan.

9. Select All Coverage Rules or Only Allowed Amounts.

10. Select Overwrite All or Fill in Blanks.

11. Click Import Values.

12. Click Save Changes. 

To adjust all procedures on a plan:

1.  Under Actions, select Adjust all Procedures. 
2.  Enter or select information in the fields:
     Covered: Yes or No
     Applies to Deductible: Yes or No
     Copay Amount – Enter $.
     Coverage Percentage – Enter %.
3. Click Apply. 
4. Click Save Changes.