Insurance Company Practice Settings

Updated: 01/14/2025 | Views: 9363

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, review Electronic Claims Options.

Configure Practice Settings

  1. Click Settings > Insurance > Insurance Companies. The Insurance Companies window opens.
  2. Find and click the insurance company name to open. The General tab of the Edit Insurance Company window opens by default.
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  1. Select the Practice Settings tab. The practice settings information displays.
  2. 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 enrollment is approved.
    • Not enrolled (default) and all other statuses prevent e-claims submission to this payer
  3. 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.
  4. 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.
  5. Click Save to record any changes.
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