Getting paid by insurance workflow

getting paid by insurance involves more than just submitting a claim from verifying coverage to posting the final payment, this guide walks you through the full insurance billing workflow in eggmed step 1 add insurance coverage to the client before you can bill insurance, the client must have active coverage on file 1 go to clients 2 select the client 3 open the coverage tab 4 click + add coverage 5 enter payer details and member information 6 save make sure the correct coverage is marked as primary (and secondary, if applicable) step 2 verify eligibility and benefits before seeing the client, it’s best practice to confirm coverage is active copay amount deductible status session limits authorization requirements you can review eligibility checks in the coverage tab under eligibility history verifying early helps prevent denials and unexpected balances step 3 create and submit the insurance claim after the appointment is completed and billed 1 go to billing in the side bar 2 open claims 3 click on new claim check this article for more detailes docid\ ljrhu6gmpppx9g3v 1p1u you can track progress under claim statuses such as draft submitted acknowledged rejected paid denied check this article for more detailes docid 9f5licnutxkmtfjqzzczb step 4 monitor claim status after submission check claim status regularly follow up on rejected or denied claims correct and resubmit if needed timely follow up helps reduce delays and improve cash flow step 5 post insurance payments once you receive payment (via check, ach, era, etc ) 1 go to billing → payment posting 2 click + post payment 3 select insurance under “who is paying?” 4 enter payer, method, check/transaction number, and total amount 5 allocate the payment to the correct charge items check this article for more detailes docid 64qq qi2zeqamhbfa4qos make sure to enter the allowed amount if applicable apply adjustments or write offs when required step 6 handle patient responsibility if there is remaining balance after insurance payment collect copays at the time of service invoice the client for coinsurance or deductible amounts post patient payments under payment posting → patient step 7 reconcile and review reports to ensure you’re getting paid correctly review total charges vs total paid in the billing tab monitor unapplied payments follow up on aging claims (ar) use billing reports to track insurance revenue and outstanding balances best practices for getting paid faster verify eligibility before the first session submit claims promptly after services are billed use correct cpt and diagnosis codes monitor rejected and denied claims weekly reconcile payments regularly