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Electronic Workers' Compensation and Auto Insurance Companies

Updated: 12/01/2023
Views: 3935

Through Kareo's clearinghouse connection with Jopari, you can set up Workers' Compensation and Auto insurance companies:

  • To submit electronic claims directly to payers that support electronic claims submission.
  • As ePaper (also known as "drop-to-paper") Payers that do not support electronic claim submission. This unique option allows your practice to submit claims electronically to Jopari where they will be printed and mailed to the payer when ready. There is no charge for the electronic submission, however, an additional fee applies for Jopari to print and mail the claim to the payer. Refer to the Paper Claims Mailing Services section of our Pricing Policy page for fee details.

Important Notes:

  • If you wish to print and mail claims to a Workers' Compensation or Auto insurance company that does not support electronic claim submission, you can set these payers up as paper-based insurance companies
  • Jopari does not support Kareo clearinghouse reports. Upon claim acceptance, you will receive acknowledgement from the clearinghouse. Claim denials are mailed to you directly from the insurance company.

Add Insurance Company

  1. Click Settings > Insurance > Insurance Companies. The Insurance Companies window opens.
    Note: The Insurance Companies window is also known as the Enrollments Dashboard.
  2. To prevent duplication, attempt to find the insurance company first.
    • If the insurance company is already added, click the insurance company name to open, review and configure the insurance company settings as needed. 
    • If the insurance company is not in the system, click +Add Insurance on the upper right of the window. The Most Commonly Requested tab of the Add Insurance window opens by default. Continue to Step 3.
  1. Click the Search Other tab.
    1. Select Worker's Comp/Auto Accident in the Type drop-down menu. 
    2. Select Jopari (WC and Auto Only) in the Clearinghouse drop-down menu. 
    3. The State auto-populates with the state where the practice is located. If needed, select a different state in the drop-down menu.
    4. Begin typing the payer's name and select it from the search results drop-down list. 
      • If the payer does not appear in the list, enter the payer's name in full and click Add to create a custom payer. 
        Note: Electronic services are not available for custom payers. Review and configure paper claims settings. 
      • If the payer is being set up as an ePaper Payer, type "paper" and select ePaper Payers #PAPER from the results drop-down.
    5. Added insurance companies display under the Selected Insurances section.
      Note: A payer that displays with an orange icon is either a duplicate in the list or is an existing insurance company in the practice.
      • To remove an insurance company from the list, click X.
  2. Once all insurance companies have been added, click Save. The Enrollments Dashboard returns with the selected insurance companies also listed.

Configure Insurance Company Settings

Once added, it is important to review and configure each insurance company's settings to ensure proper electronic claim submission.

  1. Click the insurance company name on the Enrollments Dashboard. The General tab of the Edit Insurance Company window opens by default.
  1. Review the following General settings and make any appropriate changes when applicable.
    1. The insurance company's Name.
    2. The insurance company's Address (optional).
      Note: This address is not used for claims submission. The address where claims should be sent is entered in the insurance plan.
    3. The insurance company's Contact (optional) information.
    4. Click the Insurance Program drop-down arrow and select one of the following:
      • For Workers' Compensation, select WC - Workers Compensation Health Claim.
      • For Auto, select AM - Automobile Medical.
    5. Default Adjustment (Optional): The adjustment code selected auto-populates when manually posting a payment received from this payer.
    6. Scope: Applicable for Kareo accounts with multiple practices.
      • If the insurance company was added by the currently opened practice, the scope is available for selection in the drop-down menu.
        • Practice Specific (default)The insurance company should only be available within the currently opened practice. 
        • All Practices: The insurance company should be available for selection across all practices within the Kareo account. 
      • If the insurance company was added by a different practice, the scope will be shaded and cannot be edited.
    7. Added by: The name of the practice where the insurance company was created.
    8. Notes (Optional): Notes related to the insurance company.
  2. Click the Practice Settings tab.
  1. Review the following Practice Settings and make any appropriate changes when applicable.
    Note: These settings are specific to the currently opened practice and do not affect other practices (when there are multiple) within the Kareo account.
    1. Select Enrolled in live mode in the Enrollment Status drop-down menu.
      Note: Not enrolled and all other statuses prevent electronic claims submission to this payer.
    2. Click to select or clear the selection for the following options as needed:
      • "Disable electronic claims for this payer" disables electronic claims submission to this payer.
      • "Use electronic billing when this payer is secondary" allows secondary electronic claims submission to this payer.
      • "Send Coordination of Benefits (COB) information" includes the COB information on secondary electronic claims. 
      • "Provider accepts assignment of benefits" generally indicates the provider agrees to accept what this payer allows or approves as payment in full for the claim.
      • "Exclude patient payments from claims sent to insurance" bills the total charge amount to the payer excluding any patient payments applied. 
      • "Allow zero balance transfers on claims" transfers all line items of the claim including those with zero balances. 
  2. Click Save.