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Tebra Help Center

Unpayable Encounters

Updated: 03/10/2021
Views: 3219

Unpayable encounters that should not be billed to insurance companies or patients can be entered in Kareo. To do this, a System Administrator must first create and configure an unpayable custom Payer Scenario. Once completed, approved encounters for patients with cases associated to the unpayable payer scenario do not generate claims but are saved under the Unpayable tab of the Find Encounter window for tracking and reporting purposes. 

Create Unpayable Payer Scenario

  1. Create a new payer scenario. The New Payer Scenario window opens.
  2. Enter the information.
    • Name: Enter "Unpayable".
    • Type: Click the drop-down arrow and select Unpayable.
    • "Send patient statements?" leave deselected by default so patients do not get billed.
    • Description: If desired, enter a short description for the unpayable payer scenario.
  3. Click Save. Log out and back into Kareo to use the new Unpayable payer scenario.

Associate Case with Unpayable Payer Scenario

Once the unpayable payer scenario is created, associate it to patient cases for encounters that should not be billed to the insurance companies or patients.

  1. Add a new or edit a patient case.
  2. When entering or editing the appropriate case information:
    1. Ensure "Active?" is enabled so the case is available for use.
    2. Ensure "Send patient statement?" is disabled so patients do not get billed.
    3. Payer Scenario: Click the drop-down arrow and select Unpayable.
  3. Once finished, click Save at the bottom of each window until it is no longer available.

Note: When encounters for patients with cases associated to the Unpayable payer scenario are approved, they are saved under the Unpayable tab of the Find Encounter window. Claims are not created for these unpayable encounters, but they can be tracked when generating certain reports (e.g., Encounters Detail).

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