Insurance Policy Problems (Dashboard)

problem Insurance Policy Problems is a section of your dashboard that serves as a heads up to inform you of any potential or upcoming insurance and policy related issues with clients in your system.

In this Article:

Insurance Policy Problems

From the dashboard: look for the far right column. You'll notice the section
Insurance Policy Problems shown below:

Required Role: Owner, Manager, Biller, or Therapist (financial)

Alternatively, you can click Billing & Insurance (left menu).

  • You'll see this same list on the right hand side.
  • We discuss it briefly in the article here: Billing & Insurance: Dashboard (it looks almost identical)

You may have various states or alerts listed here. Anything from a green checkmark, or issues listed by their color severity and number of to the left, shown below:

Select the  button to the right.

Here you can review any clients meeting the criteria of your selection.

  • Clicking on the Insurance Name will load the primary insurance section of their client profile
  • Clicking on the Client Name will simply load the client profile

Want to use the older insurance tab instead?

Not a problem!

Simply click on the client name loading the profile, then click Insurance (top tab).

Insurance Policy Problems: Breakdown

Below are the sections breakdown and instructions for fixing the associated problems,

Click below to jump to that section:

Expiring/Expired Policy

When a clients insurance policy is set to expire within 14 days of the current date, or is already expired.

To fix this:

  • Go to Clients (left menu)
  • Click the client name, loading their profile
  • Find the section Primary Insurance (near the bottom)
  • To the right of the Policy section click edit edit_square :

  • Change the End Date and click (top right)

Video:

Click to see a larger version

In any date field, we give you the option to either:

  • type the date
  • or click the icon event using our date picker popup

Pre-Certification Expiration

Pre-Certification Expiration warnings show on the dashboard 14 days prior to the authorization end date or 2 visits remaining, or if the end date has already passed.

To update this, go to:

  • Clients (left menu)
  • Click the client name, loading their profile
  • Find the section Primary Insurance (near the bottom)
  • Under it, find Pre-Authorizations and click edit edit_square :

  • Change the End Date and click (top right)

Video:

Click to see a larger version

In any date field, we give you the option to either:

  • type the date
  • or click the icon event using our date picker popup

Visit Limit Approaching/Exceeded

Some insurance companies and EAP's may limit the number of visits that they will cover. This alert appears when a client has 2 or fewer visits remaining on their pre-authorization.  

To update this, go to:

  • Clients (left menu)
  • Click the client name, loading their profile
  • Find the section Primary Insurance (near the bottom)
  • Under it, find Pre-Authorizations and click edit edit_square :

  • Change the Visits Allowed (or visits used)
  • When done click (top right)

Video:

Click to see a larger version

Missing Benefit Confirmation

If a client does not have an amount listed in the copay or co-insurance field in their benefits confirmation section, they will be listed under Missing Benefit Confirmation.

You can manage this under the client profile under Primary Insurance section "Benefits Confirmation" seen below:


To update this, go to:

  • Clients (left menu)
  • Click the client name, loading their profile
  • Find the section Primary Insurance (near the bottom)
  • Under it, find Benefits Confirmations and click shown here: :

Listing a copay or coinsurance amount, even if it is $0.00, is the minimum data necessary to remove the problem from the alert list:

Unverified Insurance

Any client that have recently entered their insurance information via the client portal are listed as having Unverified Insurance. Your requirement here is to select the insurance company or Third Party Payer that should be billed for this client.

To update or verify this, go to:

  • Clients (left menu)
  • Click the client name, loading their profile
  • Find the section Primary Insurance (near the bottom) and look for the orange:

Not finding it here?

  • Scroll below the active primary insurance policy and find the unverified policy
  • Click the edit edit_square button (far right):

Here we show you a page documenting what the client entered.

Here we suggest:

  • Important client entered information can be found on top in orange
  • First, at the top ensure you select the appropriate insurance company based on the client input
  • Review for accuracy
  • When finished, click (top right) when finished.

Now, you should have a dashboard that looks more like this!

🎉 Congratulations! You've cleaned up your insurance policy problems!

Hide Dashboard Warnings

Want to hide dashboard warnings for a particular insurance problem?

  • Navigate to the appropriate section previously shown above
  • Uncheck the Dashboard Warnings checkbox then click

The warning is now dismissed and will no longer show on your dashboard.