ThoroughCare offers an Insurance Coverage feature which allows practice admins to outline the percentage of services covered by that particular insurance. This can be helpful when deciding which patients are ideal candidates for programs such as CCM. If a user notices that a patient's CCM services are covered 100% they will most likely want to contact the fully covered patient before contacting a patient that will have a copay.
Navigating to the Insurance Coverage Page:
In order to navigate to the Insurance coverage page, click the "Insurance Coverage" menu option located underneath "Management".
Once on the "Insurance Coverages" page loads, take a look at the list of current defined coverages.
Note: The list shown below is empty because no insurance coverages have been defined for this practice.
Adding a New Insurance:
To add a new insurance to a practice, click the "Add Insurance" button, shown in the screengrab below.
Note: Before adding a new insurance to your site, check the list of preloaded insurance coverages to avoid adding an insurance twice. Popular insurances such as Medicare and Medicaid are already created in ThoroughCare. Jump down to the "Defining Insurance Coverage Percentage" section of this article to see how to search ThoroughCare's list of insurance coverages.
Once clicked, the "Add Insurance" pop-up will appear. Here, a user will see a number of possible fields they may use to document a new insurance; however, only the "Insurance Name" is required in order to create a new insurance in ThoroughCare.
All other fields, such as Package ID, City and Zip are all optional when attempting to create a new insurance.
Click one of the provided text fields to begin typing.
Once the user has completed the necessary information within the "Add Insurance" pop-up, they may now add the insurance by clicking the "Save" button in the bottom right hand corner of the pop-up.
Note: If a user happens to click out of the "Add Insurance" pop-up before selecting the "Save" button, all information entered will be lost.
If an insurance has been successfully created, Thoroughcare will notify the user in the upper right hand corner of their browser. If needed, click the orange message that reads "Please click here to refresh" to reload the page.
Notice that even after an insurance is added to ThoroughCare the "Insurance Coverages" list remains the same. This is because the insurance that was just created has not had its coverage percentage defined.
Defining Insurance Coverage Percentage:
In order to add a new coverage percentage, click the "Add Coverage" button located in the top right hand corner of the page.
Once the "Add Insurance Coverage" pop-up appears, click the "Primary Insurance" dropdown.
Begin typing the name of the insurance that the user would like to define coverage for. Once the target insurance appears in the dropdown list, select it.
Now that the insurance name is chosen, the user must select which program/product the insurance is covering (e.g., CCM, RPM, AWV). Click the "Product" dropdown list to select a program.
Next, select the percent of the patient's bill that will be covered by the insurance. If a practice is aware of an insurance's "Covered Amount" or a "Patient's Responsibility" for participating in a target program one may add this information to its corresponding field within the "Add Insurance Coverage" pop-up.
Once the insurance coverage is defined, click the "Save" button at the bottom of the pop-up. If a user happens to click out of the pop-up before saving, all data entered will be lost.
Notice that once the insurance coverage is saved it will appear in the "Insurance" table.
If a user wishes to edit an insurance coverage's name or address, they can simply click the "edit" button located next to the insurance's name.
Note: The "Edit Insurance" screen is similar to that of the "Adding Insurance" pop-up gone over in the "Adding New Insurance" section of this article.
If a user wishes to delete or edit an insurance coverage, they may do so by clicking either the "Edit" or "Delete" buttons located under the "Actions" column of the table.
Sorting and Filtering Coverages on the Worklist:
Notice on the worklist there is an "Insurance Coverage" column. By clicking the column header, a user can choose to sort the worklist by coverage in ascending or descending order.
Note: After an insurance coverage is defined, the target Insurance must then be assigned to a patient for the coverage percentage to show on the worklist, otherwise this column will be blank. Users can assign coverages from the patient view page.
If a user would like to filter their patients by primary or secondary insurance simply click the "Filters" button and select one of the two drop down lists and begin typing to find the target insurance.
Once the target insurance name appears, click to select it. Once selected and apply is clicked, the worklist will automatically filter the results to show only patients that have that particular insurance assigned.
For more information on defining coverages, not discussed in this article, chat with a ThoroughCare professional by clicking the blue chat bubble in the bottom right-hand corner of every ThoroughCare screen!