When a patient is covered by private medical insurance, the invoice usually goes to the insurer, not the patient. Atlacare can address the invoice to the insurer, print the claim details on it, and count down the authorised sessions for you.
Insurer billing is on the Clinic and Practice plans, the same plans as insurance authorisations.
Before you start
Add the insurer's authorisation to the patient's profile: open the patient, click Show more, then Add on the Insurance card. Enter the insurer, the authorisation code, the membership or policy number, the number of sessions authorised, any excess and the dates the authorisation covers.
You can bill an insurer without an authorisation on file, but then Atlacare can't count down sessions or warn you when they run out.
Bill the insurer
- Go to Invoices and click New invoice (or invoice straight from the appointment).
- Choose the patient.
- Under Bill to, choose Insurer.
- If the patient has an active authorisation, Atlacare fills in the insurer, the membership number and the authorisation code from it. If they have more than one, pick the right one from the list. You can correct any of the details.
- Add the line items at the insurer's agreed fee. Put the procedure code (for example the CCSD code) in the description if the insurer asks for one.
- Click Create invoice.
The PDF is addressed to the insurer. It shows the patient's name, date of birth and address, the membership number and the authorisation code, so the insurer can match it to the claim.
The patient's excess or shortfall
If the patient has to pay part of the cost, enter it in Patient pays (excess or shortfall). Atlacare prefills this with any excess on the authorisation that isn't marked as paid.
When you create the invoice, Atlacare also creates a second invoice to the patient for that amount. The two invoices link to each other, so you can open one from the other. Send each one and record payments on each one as the money arrives.
Leave the box empty if the insurer pays everything.
Session countdown
Each insurer invoice linked to an authorisation uses one authorised session. You'll see the sessions left on the patient's Insurance card.
- When only one session is left, the invoice form tells you it's the last one.
- When all the sessions have been used, or the authorisation has expired, the form warns you. You can still create the invoice (insurers sometimes extend an authorisation), but check with the insurer first.
- If you cancel an insurer invoice, its session is given back.
Finding insurer invoices
On the Invoices page, the Insurer invoices tab lists every invoice billed to an insurer. In the list, these invoices say Billed to and the insurer's name under the patient.
The accountant export has Payer, Insurer and Authorisation code columns. The membership number is included only when you show patients by name. In the Xero file, the insurer is the contact on insurer invoices and the authorisation code is the reference.
Company details on invoices
If your practice is a limited company, add your registered company name, company number and registered office in Settings → General → Invoices & VAT. They're printed at the top of every invoice. For invoices that aren't linked to an appointment, you can also set the Date of service, which is printed as the date of supply.