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US Insurance Step 2

This is the second of three steps that are required to get your account ready to use Jane’s Insurance features:

Set Up Task Task Complete
Adding Your Insurers 🥳
Assign Rates to Your CPT Codes ✍️
Location & Staff Billing Info

Step 2: Assign Rates to Your CPT Codes

If you plan to bill based on the applicable procedural codes, you’ll need to set up your clinic fees! CPT codes are required to have an assigned fee for claim submission.

 

To get started, head over to Settings, and then scroll down to the Billing Codes tab. Jane will opt you into our library of CPT code sets and ICD-10 code sets by default.

To set up your clinic CPT fees, scroll down to find our database search bar. Search to find a CPT code you use, and assign it to the appropriate fee schedules.

Here’s how it works:

  1. Use the Search bar to find a CPT code you use.
  2. Click “Assign Rate” to enter the Default Billed Amount for this CPT code in the Billed Amount box.
  3. Enter the Insurer’s Allowed Amounts associated with this procedure code.
  4. Click “Create Billing Code” to save this new code to your list.

When setting up your clinic billing code fees, you can also set up some handy defaults to save time, prevent billing mistakes, and make your insurer Accounts Receivable more realistic.

These defaults include insurer-specific Allowed Amounts and Modifiers. This allows you to account for any Contracted Rates or Fee Schedules that you might have with an insurer.

💡Pro Tips

  • Leave the Allowed Amount fields blank to use the Billed Amount instead.
  • A Procedure’s default Billed Amount, not its Allowed Amount, is sent to the insurer when billing through Jane’s Electronic Submission (EDI) feature. Allowed Amounts are only used as the basis for Co-insurance % calculations and internal invoicing.

Default Modifiers will automatically apply when adding a billing code to a visit. If you’d like to assign multiple Modifiers, you can do so by separating each two-character modifier with a space.

You’ll notice there is a box for a Default Modifier and Allowed Amount, as well as boxes for each insurance company you have set up in your Jane account. This Default box will be used if the insurer-specific box is empty, but the insurer-specific box will be favoured if you’ve filled it in.

The insurer-specific boxes are there in case some insurers you bill have different requirements for the same procedure code.

All saved billing codes for your clinic will appear in a list at the top of the page:

Continue to set up any CPT codes billed at your clinic!

It might also be a good idea to set up some favorite diagnosis codes while you’re at it, to save you a little time down the road.

Favorite codes are available for quick access when insuring a visit by using the space bar on your keyboard.

Use the search bar to search for your frequently used Diagnosis codes. Once you’ve found one of your desired codes, you’ll just need to press the “Favorite” star button.

Can’t find a CPT or Diagnosis code in our library? No problem, you can use the “New Billing Code” button in the top right corner to add in any custom billing codes that you need to bill insurance.

💡Pro Tip: If you don’t want all the codes from our library to populate when you adding billing codes to a visit (you just want your fees and custom codes to display when searching), uncheck the CPT code set box when you’re done setting up your billing codes.

Amazing! Only one more step to go 👏

Jump into Step 3 here.