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Kareo Help Center

Insurance Plans

Updated: 12/31/2019
Views: 4478

Insurance plans represent a specific policy, group or program (e.g., PPO, POS, HMO) governed by the insurance company. In Kareo, the Insurance Plan record stores the claims billing address required for sending claims. 

You will always begin with finding the insurance plan before adding, editing, or deleting an insurance plan.

Find Insurance Plan

Click Settings > Insurance > Find Insurance Plan. The Find Insurance Plan window opens.
Tip_Icon.png Tip: When there are multiple insurance plans listed, use the Look For search bar (to enter all or part of a keyword for the insurance plan) and the optional filters. Then, click Find Now

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New Insurance Plan

  1. To prevent duplication, verify the insurance plan is not in the system then click New at the bottom. The New Insurance Plan window opens.
  2. Enter the information:
    1. Insurance Company: Click Insurance Company to search and select the plan's carrier/network.
      • If the insurance company is not listed, click New at the bottom of the Select Insurance Company window and add the insurance company before continuing.
    2. The Plan Name (e.g., PPO, HMO). 
    3. Address: The address where claims should be sent. This is required for electronic and paper claims submission.
    4. Contact for Questions about Claims or Coverage (Optional): If available, enter the insurance plan's contact information.
    5. Scope: Applicable to Kareo accounts with multiple practices. 
      • If the insurance company selected for this plan has a Scope of Practice Specific, the plan's Scope auto-populates with Practice Specific and cannot be edited.
      • If the insurance company selected for this plan has a Scope of All Practices, the plan's Scope can be selected in the drop-down menu.
        • If the is plan should only be available within the current practice (to which it is being added), leave it set to Practice Specific (by default). Otherwise, select All Practices if the insurance plan should be available for selection across all practices within the Kareo account. 
    6. Created By: The name of the practice where the insurance plan was created appears once the record is saved. 
    7. Notes (Optional): Notes related to the insurance plan.
  3. Click Save
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Edit Insurance Plan

  1. Find the insurance plan then double click to open it. The Edit Insurance Plan window opens.
  2. Make the desired changes.
  3. Click Save.
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Delete Insurance Plan

  1. Find the insurance plan then click to select it > Delete. A confirmation pop-up appears.
  2. Click Yes to confirm the deletion. The insurance plan is deleted. 

Note: Only insurance plans with no other records associated, such as an encounter, can be deleted. 

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