Before you can set up a patient's insurance profile, you must first have created the Insurance companies.
Patient Profile Set up
1) Navigate to the Patient Profile > Insurance Tab and select +New Insurance.
2) Enter the following Policy Details:
Click here for additional details on individual fields
Payable To: Select from the drop-down menu to default payment when using this insurance profile to either Provider Organization, Provider or Policy Holder. You will be able to override the selection during the Telus submission process if required.
Insurance Company: Select from available companies previously created.
Depending on the selection, the required Policy/Contract/Certificate/Member ID fields * will vary.
Policy Holder: Enter the name exactly as it appears on the insurance card. By default, the patient's name will populate. Adjust this if necessary.
Policy Holder DOB: Enter the Policy Holder's date of birth. By default, the patient's date of birth will populate.
Relationship to Policy Holder: Select from the available options. By default, 'Self' will display. If choosing any other option, ensure you have entered the Policy Holder's name and date of birth correctly.
Contract # and Member ID: These should be entered exactly as they appear on the insurance card. Note that depending on the insurance, these fields may vary in label (Policy/Group/Contract, etc).
3) Policy Rules:
| Notes | You do not have to enter "Policy Rules" for the patient as Telus automatically calculates what the patient coverage will be. There may be an instance where you have to manually bill Telus, in which case you could enter the policy rules for your own tracking records. |
| Juvonno sends the claim to Telus at 100%, through the Complete and Invoice process. | |
| Telus then responds with the coverage they provide and if the Payable To is set as the Provider Organization, payment is automatically applied to the invoice. |
a) TELUS Health eClaims
This is the standard selection to bill Telus through Juvonno.
The Percent Coverage must be set to 100%.
When submitting the claim Telus will immediately respond to what is covered by insurance and what the patient portion is owed to the clinic.
b) Or you could select to use Telus Health eClaims - Category Coverage
Select this option if you want to manually track Category Coverage.
The categories would first have been set up under Settings > Product & Service Categories.
You will obtain the details for this section by contacting the individual insurance companies.
Keep in mind the patient could be using coverage elsewhere in-between visits.
Therefore, the amount entered in Juvonno may not be exact.