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Kareo Help Center

Practice Settings for Payers/Insurance

You can select settings that are specific to the practice you are logged into. This is a permission-based task; if you do not have access to configure settings, please contact your Kareo PM application administrator.

Note: Configuring the electronic enrollment status for a specific insurance company is different than configuring the enrollment status for an entire practice. To learn about configuring the enrollment status for a practice, see Electronic Claims Options.

To configure practice specific settings

  1. Click Settings > Insurance > Find Insurance Company.
  2. Once you find the insurance company, double-click to open it.
  3. Click the Practice Settings tab. Select your settings. See below.
    Note that the selections you make are specific to the practice you are logged into and do not affect other practices on your Kareo PM account.
  4. Click Save.

Practice Settings Tab

Insurance Company - Practice Settings.jpg

  1. Enrollment Status: Once the practice has been approved for sending electronic claims to this insurance company, select “Enrolled in live mode” from the drop-down list.
  2. Options:
  • Disable electronic claims for this payer: Check this box to disable electronic claims for this insurance company.
  • Use electronic billing when this payer is secondary: Check this box to use electronic billing when this insurance company is the secondary payer.
  • Send Coordination of Benefits (COB) information: Check this box to send coordination of benefit information.
  • Provider accepts assignment of benefits: This box is checked by default. This information will populate the appropriate field on the CMS 1500 form (box 27) and/or on the electronic claim message. Uncheck this box only if the provider or group of providers within the practice does not accept assignments.
  • Exclude patient payments from claims sent to insurance: Check to set the "Amount Paid" field on the CMS 1500 form as $0.00 and exclude any patient payments from the "Balance Due" field. This enables you to bill the full charge amount to the payer, even if a patient payment has been applied. 
  • Allow zero balance transfers on claims: Check to transfer all line items on a claim, including those with a zero balance.
  1. ICD-10 Date: Displays the payer's conversion date to ICD-10 coding. If the insurance company is set up as a commercial payer, this date is grayed out and cannot be changed. If adding a Workers' Compensation payer, you can select the date to begin submitting ICD-10 codes.

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