Billing an insurer instead of the patient
Add the insurers you work with, set how each one covers a visit, and follow a claim from billed to paid without mistaking it for revenue too soon.
Open this page in the appA covered payment is not revenue until the insurer actually pays it — until then it is a claim, money the clinic is owed. The Insurance page keeps that distinction visible everywhere: how much has been collected from patients, how much has been received from insurers, and how much is still outstanding are always shown separately.
Setting up an insurer
Add each company your clinic works with, and choose how it covers a visit: a flat percentage, a fixed amount, a rate per specific service, or a manual amount typed in at payment time. A copay and a per-visit cap can be added on top of any of these. A patient's own policy — their card number and validity dates — is recorded on their profile; an expired card is flagged before payment is taken, since an expired policy is the most common reason a claim is rejected.
At the payment screen
Choosing an insurer at payment splits the bill automatically: the insurer's share and the patient's share are shown live, and the coverage is recalculated on the server at the moment of payment rather than trusted from what the screen showed a minute earlier.
- Choose the insurer and, if the patient has one on file, their policy.
- Review the split — how much the insurer covers and how much the
- Confirm the payment. The claim is created in the same step, so the
Following a claim
A claim moves through pending → submitted → approved (or partially approved, or rejected) → paid. Rejecting a claim requires a reason, since that reason is what a clinic needs to appeal it or re-bill the patient. The Insurance page's per-insurer view lists every claim with its status and flags any that are overdue for filing, so nothing is left open by accident.
