1. Policy Rules must only be set to Telus Health eClaims.
2. Your system insurance default must be set to 100% coverage.
3. Telus only allows primary insurance billing through Juvonno. You can accept payment from patients for balances owed that Primary insurers don't cover.
4. Manulife does not provide Predeterminations. You are unable to select "Check Coverage" for this insurance company. When you are submitting claims for this insurer you will bypass the Check Coverage option and go right to the Complete and Invoice option.
5. 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
You will have to select the Terms and Conditions check box and then select Submit to get the predetermined amount.
The system Check Coverage 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.
b. Complete & Invoice
From the schedule select Complete & Invoice. The submit via Telus check box will be selected.
Select Checkout. If you do not want to submit the invoice through Telus deselect the telus check box.
You will receive a Submit Claim popup. Confirm to send 100% of the amount of the invoice to Telus by selecting the Submit button.
On the Submit Claim popup, select the Terms and Conditions check box and then Submit.
The patient appointment block on the schedule will indicate "Billed".
Telus will respond immediately with the total amount covered.
You will have the option to generate a PDF (Explanation of Benefits).
If there is a percentage owed by the patient, you will be able to accept payment from the patient.
The example below shows the split between the insurance company the patient portion.
The Amount of the transaction is $83.0 the amount paid by insurance is $15.30 and the balancce owing by the patient is $67.70.
Select Collect Balance Owing.
The Receive Payment popup will open, 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 statement with the payments.
|Note||Telus invoices are automatically paid off in Juvonno when the transaction takes place from the invoiced appointment on the schedule. To change this so the invoice show as receivable until you receive payment go to Settings, General, Integrated Apps, Telus, set the Automatically Apply Payments field to No and Save.|
To reconcile go to Accounting, Invoice Search.
Set your search parameters based on the Statement you received.
Set the start and end date.
Set the Status field to Paid unless you have changed this setting to not pay telus invoices off as soon as they are submitted.
Select the Third Party etc. and search.
Match the information on the insurance company statement with the list of transactions at the bottom of the page.
If they do not match do not include them in this batch you are paying leaving and pay them off separately.
If they don't match you can click on the icon to the left of the item and select Pay Invoice option.
Then select the option to "Split" the invoice and enter the amount the insurance covered and what the patient owes.
The next popup is the Split Invoice details.
Click the Add button to open the Patient field.
In the Patient field enter how much they owe for the invoice and in the insurance field enter the amount they paid. The invoice will split it between the 2 when you save. As in the example below the insurance covered $70.00 and the patient owes $30.00.
Go to Reports and select the Day End option. The Telus items will appear on this report.
Go to Reports, Payments Received, there is an option to select Telus payments.
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. 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.
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.
|Note||Claims submitted to Telus using an API such as Juvonno do not appear in the Telus portal.|
|Only claims submitted directly through the Telus portal will appear on their portal.|