Understanding Insurance Setup and Maintenance
As a user of AcuityLogic On-Premises, you receive AcuityLogic with the latest insurance carrier and plan information as well as a default version of each insurance schedule. Review all insurance information in AcuityLogic to make sure it meets the needs of your practice, and record your receivables for each plan. After going live with AcuityLogic, it is your company’s responsibility to update and maintain all insurance information.
You must set up different layers of insurance, starting with carriers and moving toward the attributes of each plan’s schedules of benefits:
- Carriers — When setting up insurance, first set up insurance carriers. Since you receive AcuityLogic with the latest carrier information, review the carriers and ensure that all settings meet the needs of your practice. After going live with AcuityLogic, it is your responsibility to add carriers if you need new ones. See Setting Up Insurance Carriers.
- Plans — After setting up carriers, review the insurance plans in AcuityLogic and ensure that the plan settings meet the needs of your practice. After going live with AcuityLogic, it is your responsibility to add insurance plans if you need new ones. See Setting Up Insurance Plans.
- Schedules — After setting up your plans, review the insurance schedules and record your receivables for each schedule. An insurance schedule is a schedule of benefits offered by an insurance plan. You receive AcuityLogic with a default insurance schedule for each plan, and you can create multiple insurance schedules, called versions. After going live with AcuityLogic, it is your responsibility to add insurance schedules if you need new ones. See Setting Up Insurance Schedules.
- Methods and Attributes — An insurance schedule is made up of methods. A method is a specific benefit for a specific item type and is made up of attributes. An attribute specifies the allowance, receivable, or other component of an insurance benefit. AcuityLogic includes all the methods and attributes needed to create insurance schedules. See Understanding Insurance Schedule Methods and Method Components.
The following chart shows the layers involved in insurance setup and provides an example from each layer.
Before you create invoices and bill claims, review and set up any necessary CPT codes to ensure that all claims are accurate.
Depending on the needs of your practice, you may also need to review or set up VSP insurance information, configure screen scraping, and map insurance rejection reasons.