How to calculate insurance WITHOUT using Insurance Estimating

How to calculate insurance without using Insurance Estimating:

There is the option to not use the Insurance Estimating feature. Users will still be able to calculate insurance by assigning categories but you will not be able to create specific coverage tables.

Before continuing, it is very important to determine how you want the fee amount to show in the Ledger and in the Insurance Claims.

If you want to show the UCR amount, please follow the instructions on how to enable Insurance Estimating here. If you want the Insurance fee amount to show in the Ledger, please follow instructions below.

Initial Configuration

Make sure the Insurance Estimating box in Edit Control table is unchecked. To access this checkbox, go to Setup>Site Configuration>Edit Control Table>Application Settings tab.

How to Activate Multi Fee Schedules:

Go to Setup>Site Configuration and select Edit Control Table.
On the Application Settings tab, check the box next to Enable Multiple Fee Schedules.

Adding a new Multi Fee Schedule:

Note: if currently using fee schedules, make sure all fees have categories if applied to the specific fee.

Go to Setup and select Program Setup, Select the Fees listing/ADA codes option.

Click on New Multi Fee.

Click on New.

Name the New Multi Fee.

Click the Close button to close the window.

List fees as either A/B/C under the Fee Category drop down.

Attaching a Fee Schedule to an Insurance

After setting up your multi fee schedules you can attach them to an insurance in the system so that it automatically pulls the correct fee schedule corresponding to the insurance chosen under the insurance tab.

Go to Insurance Tools drop down along the upper bar then click on View/Edit Insurance Co. Information.

Attach the Multi Fee Schedule that corresponds to the insurance company you select in the Pick Company To View drop down.

Save and Close once finished.

Go to the Insurance Tab and locate the boxes for Categories A/B/C.

Add percentages.

These will calculate percentages corresponding to the category chosen in the fee schedule.

Go to Fees Page
- Note: if a Multi Fee Schedule is linked to an Insurance company, the name of the Multi Fee will be showing in Multi Fee dropdown. If not using Multi Fee Schedules, it will show the “Default” multi fee.
Add the fee(s), and post or post all.
- Note: The fee amount posted in the Ledger will be the Insurance fee so if a claim is created, this will also show the Insurance fee.

Article ID: 738
Created: January 2, 2019
Last Updated: October 11, 2023
Author: TDO KB [web_admin@tdo4endo.com]

Online URL: https://kb.tdo4endo.com/article.php?id=738