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Insurance Company Practice Settings

Updated: 11/30/2023|Views: 8191

The Practice Settings of the insurance company allows you to select paper and electronic claims (e-claims) billing settings specific to the currently open practice and does not affect other practices (when there are multiple) within the Tebra account.

Note: To set the enrollment status of electronic claims billing for the entire practice, go to the Electronic Claims Options.

Configure Practice Settings

  1. Find the insurance company then click the insurance name to open. The Edit Insurance Company window opens.
  2. Click the Practice Settings tab. The Practice Settings information displays.
  3. Select the appropriate practice settings for the insurance company.
    1. Enrollment Status: Click the drop-down arrow to select a status.
      • Enrolled in live mode: Select this status to allow e-claims submission once this payer's Claims status shows as Approved on the Enrollments Dashboard.
      • Not enrolled (default) and all other statuses prevent e-claims submission to this payer.
    2. Click to select or clear the selected options as necessary:
      • "Disable electronic claims for this payer" prevents e-claims submission to this payer.
      • "Use electronic billing when this payer is secondary" allows secondary e-claims submission to this payer.
      • "Send Coordination of Benefits (COB) information" includes the COB information on secondary claims.
      • "Provider accepts assignment of benefits" populates Box 27 of the CMS-1500 paper claim form and Loop 2300 CLM08 for e-claims.
      • "Exclude patient payments from claims sent to insurance" bills the total charge amount to the payer even if patient payments were applied. This option populates Box 29 of the CMS-1500 paper claim form and Loop 2300 AMT02 for e-claims with $0.00.
      • "Allow zero balance transfers on claims" transfers all line items of the claim including those with zero balances.
    3. ICD-10 Date: The payer's conversion date to ICD-10 coding.
      • If the payer is set up as a commercial payer, the date is shaded and cannot be changed.
  4. Click Save to record any changes.
Desktop_InsCoPracticeSettings_Save.png

 

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