 |
| Insurance Organizations |
 |
- TheraManager is a top-down program, so you only need to set up an insurance organization or plan once, although there is an option to do insurance plan details by patient.
- TheraManager reflects the industry distinction between Insurance Organizations and Plans.
- An Organization is the entity to whom CMS -1500 Forms are sent, from whom Reimbursements for patients may be combined in one payment check, and who use common Provider Numbers and have the same Allowed Amounts for a given provider. Providers also contract with these entities and they set the allowed amounts.
- TheraManager tracks all the information associated with each Organization and Provider, eg allowed amounts for each CPT code and in the case of Medicare by location and participation.
|
| Insurance Plans |
 |
- Insurance Plans are shown associated with specific organizations.
- TheraManager allows you to keep the Plan information either as common to many patients or by patient.
- The stored plan information includes the initial and final copayments with the threshold amount of dollars or visits, annual deductible and maximum that are used for estimated billing.
- Keeps a record of whether a plan is Managed Care as this will determine whether a Patient requires authorizations.
|
|
