1. Your system insurance default must be set to 100% coverage.
2. Telus only allows primary insurance billing through Juvonno. You can accept payment from patients for balances owed that Primary insurers don't cover.
3. Sunlife and Manulife do not provide Predeterminations, you are unable to select "Check Coverage" for these insurance companies. When you are submitting claims for these 2 insurers you will bypass the Check Coverage option and go right to the Complete and Invoice option.
4. You are able to confirm the submission by checking directly on the Telus portal. It could take up to 24 hours for the submission to be visible.
When the patient has completed their appointment, click on the appointment block and select the "Check Coverage" option.
If you are not using the "Check Coverage" option select "Complete and Invoice".
a. Check Coverage Option
The system Predetermination popup will show 100% of the total invoiced. Select the Terms & Conditions box then select Submit.
The second popup shows the amount being approved. If there is no coverage the Approved Amount will show $0.00 .
If there is partial coverage the details will indicate the portion covered by Telus and the portion owed by the patient.
The example below shows a split invoice where the patient will owe a portion.
Select the "Generate PDF" button if you would like to see the insurance Form with approval details. You are able to print the form. Close the popup.
b. Complete & Invoice Option
From the schedule select Complete & Invoice where you will see under the Insurance field that the coverage is with Telus. Select Checkout.
You will receive a Submit Claim popup. Confirm to send 100% to Telus by selecting the Submit button.
On the Submit Claim popup, select the Terms and Conditions check box.
The patient appointment block on the schedule will indicated "Billed" at this point in the process.
Telus will respond immediately with the total amount covered.
Again you will have the option to generate a PDF.
If there is a percentage owed by the patient, you will then be able to accept payment from the patient.
The example below shows the split between the insurance company the patient portion.
Select Collect Balance Owing.
You will then get the Receive Payment popup where you can select the method of payment you are collecting from the patient.
The invoice will indicate Telus for the portion covered by the insurance.
Receive Payment from the Insurance Company
You will receive the payment from the insurance company by check or direct deposit.
You will then need to reconcile the invoices with what you received.
Go to Accounting, Invoice Search.
You can set your search parameters based on the reconciliation, set the start and end date, select the Third Party etc. and search.
Match the information on the reconciliation to ensure the invoice totals match.
If they do not match you will void the invoice and adjust the invoice accordingly to make sure if the patient still has an outstanding amount is reflected correctly on the invoice.
Go to Reports and select the Day End option. The Telus item will appear on this report.
Open the Patient Profile, go to the History tab then the Invoices tab. The item will appear as paid and the invoice will indicate what portion is paid by Telus.
a. Destination Error
You may get a Telus response showing "Destination Error". There is an option to Retry Submission. We suggest you wait about 1 minute and try to submit the claim again. If you get the same message you are able to select "Void". This will void the transaction in Juvonno. We suggest when you do this that you log into the Telus portal and try to submit the claim manually. There may be an instance where the claim actually did go through. If you are notified the claim has already been submitted, you can pay the claim off manually in Juvonno.
To bill the patient manually click the appointment block on the schedule and select "Re-Invoice", deselect the Telus checkbox and bill the patient manually.
When you go through the Telus portal you may receive a Pending prompt meaning the claim has not been approved or declined.
This means the insurance company received the claim but needs to review it before paying it.
The provider will need to contact the insurer 24 – 48 hours after the submission to confirm the payment amount.
The provider can also inform the patient that their insurance did not provide a response, void the claim and charge the patient. If the patient agrees, the claim can be resubmitted with the insured member as the payee, so they receive the reimbursement from the insurer.
c. Voiding a claim
You are unable to Void/Nullify a Claim during the submission process however this option is being built into Juvonno in the near future.
I necessary, Void the Claim in Juvonno manually and contact the Insurance company to Void the claim directly.
Claims submitted to Telus using an API such as Juvonno do not appear in the Telus portal. Only claims submitted dirctly through the Telus portal will appear on their portal.