Billing/Insurance

Insurance Entry

From Check In Window, click into the Insurance row
From Patient's Chart, click the 3 dots in the top right corner, select Insurance

Choose Auto Accident, Worker's Comp, Travel Ins if appropiate
Choose Sign Up Without Insurance if the patient is paying out of pocket
Choose Enter Insurance Info if the patient has medical insurance

Medical Insurance Form Details

1. Enter insurance provider name, member ID, group number (if available)

2. Select patient's relationship to the subscriber of the insurance plan

3. If patient is subscriber, enter in the patient’s name, date of birth, address, and sex assigned at birth, then click save insurance

4. If patient is not subscriber
   Enter in the subscriber’s name, date of birth, address, and sex assigned at birth
   Enter in the patient’s name, date of birth, address, and sex assigned at birth
   Click save insurance

5. Real Time Eligibilty (RTE) check will run

6. If an Independent Physician Association (IPA) is found, it will be suggested to the user to enter in step 1

Real Time Eligibilty (RTE) Results

Specific steps to proceed

1. Please enter in the correct id.
   This is an indication that the Member ID is entered incorrectly, please review

2. RTE found an associated IPA: Name. Please select the IPA.
   This is a notice to enter the IPA listed in the yellow banner in the respective field

3. RTE found an associated IPA: Name. Please make sure the correct IPA has been selected.
   This is a notice that the current IPA selected in the form is incorrect, and to change to the one in the yellow banner.

4. Your insurance coverage is inactive. Please submit active coverage.
   This is a notice that the insurance details entered is no longer an active plan. Request current insurance information from the patient.

Unable to Verify Insurance

This means that the RTE was not able to connect to the Insurance company to verify the insurance in real time given the information entered. Users should verify the information entered into all steps outlined above is correct.
A copay will not generate to be collected at check in, but users can proceed

Your insurance is all set up

This means that the RTE was able to successfully verify the insurance in real time with the information provided.
If there is a copay associated with the patient's plan for the type of visit, one will be suggested in the check in flow.

NOTE: A successful verification of insurance does not guarantee the insurance if In-Network the the facility.

How To enter Auto Accident Insurance in Carbon EHR

1. Accessing Patient Information

   • Click on the patient's appointment card.
   • Select responsible party as insurance.

2. Selecting Auto Accident Insurance

   • If patient already has insurance, change it by clicking into the row and selecting auto.
   • If patient does not have insurance on file, click on the add button and select auto accident.

3. Entering Insurance Information

   • Select the insurance provider by typing in the name.
   • Enter policy number, case or claim number (use placeholder if not available), date of the accident, state of the accident, at-fault party's information.
   • Optional: Enter insurance agent details or any important notes.

4. Completing the Setup

   • Enter patient's address if not on file.
   • Review and confirm the entered information.

5. Updating Insurance for Previous Visits

   • Go to the patient tab and search for the patient.
   • Find the appointment where insurance needs to be added.
   • Update insurance information by selecting insurance as the responsible party.

6. Finalizing the Process

   • Review the entered information.
   • Confirm that all necessary details are accurate.
   • Save the changes.

See video here (opens in a new tab)

How to edit agreements

1. Accessing Agreements

   • Click on the settings icon
   • Select agreements

2. Sections to Update

   • Privacy Notice
   • Consent to Treatment
   • Consent to Telehealth

3. Editing Verbiage

   • Edit existing text or start fresh
   • Use formatting options like headers, bold, italics, numbering, bullet points, etc.

4. Customizing Sections

   • Toggle on/off sections based on your practice's needs

5. Saving Changes

   • Click save to update changes
   • Updates will reflect in the patient app and booking flow for future appointments

6. Impact on Existing Patients

   • Patients who have already signed agreements will retain the previous content -New patients signing agreements post-update will see the updated content

See video here (opens in a new tab)

How to refund patients

1. Accessing Patient Details

   • Start in the Patients tab
   • Click on the calendar icon and select View Details

2. Navigating to Review Bill

   • Go to Review Bill by expanding Checkout and selecting Review Bill
   • Alternatively, click the three dots and choose Review Bill

3. Reviewing Payments

   • Scroll to the Total Payments section to view all payments

4. Initiating Refund

   • Click on the information icon to see payment details
   • Enter a specific reason for the refund
   • Input the refund amount. If refunding the entire amount, leave it as is
   • Click refund to process the refund in the original payment method

See video here (opens in a new tab)