.png){kind=logo}
Why did I receive a Missing Benefit alert?
Are you seeing a Missing Benefit Confirmations or Needs Confirmation Alert on your Home or Billing Screen?
Read details below to understand why, as well as fixes!
In this Article:
Missing Benefits Confirmation
The system recognizes this client/patient has insurance, but the system cannot find evidence of what the client owes you for their copay/coinsurance amount.
How to Fix the Alert
Clicking the Missing Benefit Confirmation section. The alert takes you to the report of Missing Benefit Confirmations.
This will take you to the report, showing each client matching the criteria:
Options:
- To add benefits: click the Insurance, bringing you to the client profile: insurance section
- To dismiss a client from this list: check the box beside the client name & click
After loading the insurance section within the client profile:
- Find the Benefits Confirmation section
- Click +
- This loads the benefits editor:
- Enter any applicable information
- We recommend entering at least the copay or coinsurance amount
- We assign the client’s responsibility for the service as the amount listed in the Usual Fee or Copay box
Why Did This Happen?
We assign the client’s responsibility for the service as the amount listed in the Usual Fee or Copay box. Without the usual copay or co-insurance amount listed, the entire responsibility is placed on the client, as due and payable, when that is not likely to be the case.
Locating Patient Copay/Co-Insurance Responsibility Details:
Insurance companies typically offer logins to their websites:
You can look up the patient's expected copay/co-insurance amounts due to you at the time of session.
Look at a copy of the patients insurance card:
If the card lists a standard copay amount for visits to their primary care physician, this is most likely the copay amount that would be due for mental health services.
If the insurance card does not include information about a copay on it, it's likely this patient has a deductible plan where a deductible must be met before insurance pays any portion of your services.
In these cases, enter in the insurance company's 'allowed amount' for your services. Although this is a good 'rule of thumb' to get started with, we do highly recommend that you then review the insurance company website for benefits.
Additionally, review your initial explanation of benefits for these patients when the first session payments come in from the insurance companies:
If different than what you listed, adjust the copay/co-insurance amount in the patient's insurance profile accordingly so that you are accurately collecting the correct amount for the next service.