Understanding the Insurance Estimation Process (Updated July 2020)

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Description

This quick guide provides an overview of the updated insurance estimation process in Curve Hero. 

 

Note

The Patient amount of a line item can no longer be edited. Only the Insurance estimate and Total amount can be updated. 

 

Steps

The following topics are covered in this quick guide:

• Section I - Understanding How the Total Amount and Amount Owing are Calculated
• Section II - Updating the Insurance and Total Amounts

Section I - Understanding How the Total Amount and Amount Owing are Calculated

In the Billing module, the Total amount and Amount owing are calculated as indicated below:

• Total

  The Total amount of a line item is calculated as follows:

  • Total (3) = Insurance estimate (1) + Patient amount (2)

    

• Amount owing

  The Amount owing for a line item is calculated as follows:

  • Amount owing (4) = Insurance estimate (1) + Patient amount (2) - Total payment amount (3)

    

Section II - Updating the Insurance and Total Amounts

In the Billing module, the Insurance estimate and Total amount can be updated as indicated below:

• Updating the Insurance Estimate

  1. In the applicable line item, click the Insurance amount.

     

  2. In the drop-down menu, click the Insurance estimate amount.

     

  3. Enter the updated Insurance estimate amount.

     

  4. To update the Deductible, click the Deductible estimate amount.

     

  5. Enter the updated Deductible estimate amount.

     

  6. The Insurance estimate and Patient amount is updated.

     

• Updating the Total

  1. In the applicable line item, click the Total amount.

     Note: Updating the Total amount will trigger a re-estimation of the Insurance amount using the coverage table assigned to the patient's account. Manually entered amounts will be discarded if the Total is updated.

     

  2. In the drop-down menu, enter the Total amount.

     

  3. The Total amount and Amount owing are updated.

     Note: The Insurance estimate and Patient amount are automatically recalculated.

     

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