Documentation
Insurance and Claims
5 guides on Insurance and Claims in Ventrecs. Each guide says who it is written for and lists the steps in order. Start with “Record and verify patient coverage”.
Record and verify patient coverageA coverage links a patient to an insurance plan. When a service is charged, the plan decides how much the patient pays and how much goes to the payer.
Check eligibility with the payerAn eligibility check asks the payer whether the patient is covered for a service date. Each check is saved as a permanent record.
Request pre-authorisationA pre-authorisation is the payer's approval, before the service, to pay for an expensive or restricted service.
Prepare and submit a claimA claim bundles the covered services of an encounter and sends them to the payer. It moves through fixed steps, and each step has its own button.
Set up payers, plans and payment flowsPayers, plans and payment flows define who pays for what. Only a billing manager can change them.