We have an insurance company that we are no longer in network with and they send the payment directly to the patient. The insurance company said they do not send us a statement or any information as to whether they paid the patient, etc.
I have changed the inurance plan tab on some of these to benefits to patient, but apparently that doesn't do much.
I need the claim to go to the inursance company. Then I need it to bill the patient and in many cases these patients have double coverage, where the secondary insurance needs to be triggered.
Can someone tell me the proper set up in the system and how it will work?
You are on the right track. First collect all the money from the patient at checkout. You have the correct switch enabled on the plan. You will be prompted to submit the claim, when you transmit the claim electronically you will be messaged that claim has benefits to patient and will ask you to delete the claim which is what you want because you won't receive the payment or EOB to be aable to close the claim and you don't want it as open insurance because it can delay their statement depending on the ICM method you have enabled for that account. When you print the claim to paper it will ask to delete the claim, delte the claim. You will still be able to submit secondary but again you won't have any eob to submit it unless patient provides it to you.but you can give them a copy of the printed submitted claim and they can mail it on their own with their EOB from primary. This is the best approach.Please contact me directly if you have any further questions.