How to Add Extended Health Insurance to a Patient Profile

This article explains how to add an extended health insurance policy to a patient's profile in Juvonno. You will learn how to enter policy information, configure coverage settings, assign billing order, and understand special requirements for TELUS eClaims insurers.

When to Use This

Use this article when:

• A patient provides new extended health insurance information.
• An existing patient needs an additional extended health insurance policy added to their profile.
• You need to configure coverage details for a patient's insurance plan.

Key Rules for TELUS eClaims Insurers

The following requirements are determined by TELUS eClaims insurers and are not limitations imposed by Juvonno. These rules apply to all TELUS eClaims submissions.

• A TELUS insurer must be the patient's primary insurance in order to be submitted through Juvonno.
• If a TELUS insurer is secondary, it cannot be direct billed. The patient must pay for the appointment and submit the claim to their insurer themselves.
• If a patient has both a TELUS insurer and a non-TELUS insurer, direct billing is only possible when the TELUS insurer is primary and the non-TELUS insurer is secondary.
• If a patient has two TELUS insurers, only one insurer can be submitted electronically through the clinic. The patient must submit the second claim themselves.
• Billing order must always reflect the patient's actual insurance order, and only eligible TELUS insurers can be submitted through TELUS eClaims.

Examples 

What You Need

Before you begin, ensure you have:

• The patient's insurance card or policy information.
• Any required policy numbers, member IDs, certificate numbers, or group numbers.

Permissions

• Your User Type must have access to the Insurance section in the Patient Profile 
  • If you don't see this, contact your clinic's administrator 
  • User Types can be updated by an Admin Level 2 

Adding Insurance to a Patient Profile 

1. Open the patient's profile 
2. Select Insurance 
3. Click + New 

The Patients / Insurance window will open. 

4. Complete the Policy Details section: 

    

   Payable To	Select who should receive payment For most clinics, this will be Default (Provider Organization)
   Insurance Company	Select the insurance company from the dropdown list
   Policy Holder	Enter the policy holder's name exactly as it appears on the insurance card By default, the patient's name will auto-populate in this field
   Relationship to Policy Holder	Select the appropriate relationship  If the relationship is anything other than Self, ensure the Policy Holder and Policy Holder DOB are entered correctly
   Policy Holder DOB	Enter the Policy Holder's date of birth By default, the patient's date of birth will auto-populate in this field
   Policy Information	Enter all policy numbers exactly as they appear on the insurance card Field names may vary by insurer, such as: Policy # Plan #  Member ID Certificate # Contract #  Group #
   Custom Label	Optional:  This allows you to display a custom name for the insurance policy If left blank, the insurance company name will be used

    

5. Complete the Policy Rules section:

    

   For TELUS eClaims insurers

   Leave the Policy Rules settings unchanged Ensure coverage is set to Percentage Coverage 100%

   For non-TELUS insurers (e.g., Greenshield, Blue Cross, Sunlife)

   Select the appropriate Coverage Type: Default Use when coverage percentages are the same across all service categories Example: All services covered at 80%. Block Fee Use when a patient has been approved for a fixed dollar amount of coverage  Enter: Start Date End Date (if not available, select date 2 years in the future and update later)  Coverage Amount The remaining balance decreases as services are billed Per Category Use when coverage differs by service category Example: Chiropractic: 80% Massage Therapy: 100% Per Detailed Category Use when coverage needs to be tracked at a more detailed service level Refer to the article: How to Set Up Per Detailed Category Coverage Insurance

6. Complete the Other section: 

   Billing Order	If the patient has multiple insurance plans, choose the order in which they should be billed TELUS eClaims insurers must be billed first when claims are submitted
   Status	Active: Insurance can be used Inactive: Insurance is no longer applicable
   Notes	Add any internal notes related to the insurance policy

7.  Click Save 

Result

The insurance policy is added to the patient's profile and can be selected during appointment invoicing and claim submission.

Avoid Common Issues

• Enter policy numbers exactly as they appear on the insurance card
• Verify the policy holder's name and date of birth when the relationship is not Self
• Do not modify Policy Rules for TELUS eClaims insurers
• Ensure TELUS eClaims insurer is the primary insurance when a patient has multiple plans
• Confirm that the insurance status is set to Active before attempting to bill the policy

Troubleshooting

The claim was rejected. 

• Review the Explanation of Benefits (EOB) returned by the insurer.
  • If the EOB indicates the claim was rejected by the insurance company, the patient should contact the insurer directly for clarification. Juvonno only transmits the claim and cannot override insurer decisions regarding eligibility, coverage limits, policy status, or claim approval.
• Common insurer rejection reasons include:
  • Coverage has been exhausted.
  • The policy is inactive.
  • The policy information was entered incorrectly.
  • The service is not covered under the patient's plan.
  • Additional information is required by the insurer.

Required insurance fields are missing.

• Only TELUS eClaims insurers will have mandatory fields marked with red asterisks
• If no asterisks appear, policy information can be entered into relevant fields based on what the client's insurance card is showing (e.g., if it says Plan #, then enter the information into Plan#)  

I don't know if the insurer is a TELUS eClaims insurer.

• Check directly with TELUS eClaims to learn which insurance companies are participating insurers

• Juvonno will automatically indicate whether the insurer participates in TELUS eClaims when you select an insurance company in the Insurance Company dropdown. 

  Signs that the insurer is a TELUS eClaims insurer include:

  • Required policy fields are marked with red asterisks

     

    

     

  • A blue information box appears in the Policy Rules section

     

    

If neither of these indicators appears, the insurer is not configured as a TELUS eClaims insurer.