Ensora Mental Health Ideas Portal
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Status Future consideration
Categories Billing & Payments
Created by Guest
Created on Jun 24, 2022

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Bill insurance based on DOS and effective dates

Rather than billing whichever insurance is active at time of claim submission, the system should bill the correct insurance for the DOS based on the effective dates of the client's insurance. This should work both for past, inactive insurances as well as for insurances that will become active in the future (for instance, at year end). The correct payer should also reflect on relevant screens and reports for the DOS.

App Type Provider App
  • ADMIN RESPONSE
    Aug 23, 2024
    When submitting a claim or checking a claim for errors, a date of service check will be performed. The claim will be submitted to the appropriate payer based on the effective dates for that client’s payers. This additional check was added to help prevent denials. Check out our release notes for more information.
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    • Rebecca Moore
      Sep 16, 2022
      Can there be an easier method to move payment responsibility after insurance has been marked as inactive? Once the insurance has been marked as inactive, the balance is stuck as 'insurance' on the invoice.
      Reply
    • Guest
      Aug 18, 2022
      Each year we have so many clients that will change to new plans, and while we gather all the information ahead of time, it just leads to still so much manual work on the 1st of the year that we need to do - billing for the last day of the month, then editing the insurance, adding in the copay, making that insurance effective, etc. Do you have an automated way that we can put in a new insurance with a future effective date, so that we may enter in all the information we gather at the time we receive it? We have heard from other platforms that they have a way to mark an old insurance with a future end date and add a new insurance with a future start date, would you have a way to accommodate this?
      Reply
    • Greenhouse Therapy Center
      Jul 7, 2022
      When a client starts using a new insurance plan, we are often still waiting for payments from their old plan. Please allow for claims matching with inactive plans.
      Reply
    • Guest
      Jun 27, 2022
      Have a client's claim be billed to the correct insurance based on the effective dates, even if that insurance is no longer active.
      Reply
    • Guest
      Jun 24, 2022
      Currently if the insurance is marked as inactive we are unable to bill the insurance even if the date of service was during the active period. then we have to go in and reneter all of the insurance info since we cannot reactivate the inactive plan. This defeats the purpose of entering an end date to the insurance. Also, we then have to remember to go back and mark the insurance as inactive after the session was billed.
      Reply
    • Guest
      May 31, 2022
      We should be able to submit claims to an inactive insurance plan as long as the date of service is before the end date. Otherwise we have to manually re-enter the insurance information and submit the claim (or edit/resubmit it in some cases) and then deactivate the insurance again. Leaves a lot of room for error to potentially keep billing a closed plan.
      Reply
    • Guest
      Mar 5, 2020
      When a patient gets new insurance it automatically changes the previous claims that were submitted to the old ins to the new ins. For example If you bill a claim for 12.28.19 under their Optum Ins and then they switched to Anthem for Jan and you bill a claim to Anthem on 1.8.20 . If the claim is still pending in the ledger the 12.28.19 claim auto changes to the insurance. That is very problematic.
      Reply
    • Guest
      Jul 23, 2019
      Currently, when sending a claim to Awaiting Submission it automatically renders the payer as whatever current active primary insurance payer the client has on file. This is not ideal when dealing with claims that haven't been paid by an insurer that has been marked as Inactive.
      Reply
    4 MERGED

    Bill payer based on effective dates

    Bill & display the appropriate payer in TheraNest based on the effective date of the payer.
    Michelle Siev 11 months ago in Notes & Cases 0 Future consideration
    12 MERGED

    Allow insurance to become active for future date

    Allow me or my clients to update their insurance information with a future start date and then have that insurance kick in on that effective date. This would be very helpful for clients who are changing plans for the new year.
    Guest over 1 year ago in Billing & Payments 2 Future consideration