Insurance Coverage and Coverage Reports

TheraPlatform offers insurance coverage verification and coverage reports under Pro and Pro Plus Plans. This feature allows you to check if your client has an active insurance and generate and view coverage reports.

Important: Please, note that not all payers (insurance) offer this service. Additionally, this service is not free. Data provided by the payers varies by each payer. TheraPlatform displays only data returned by the payer. To verify benefits and eligibility- please call the payer directly.

Note: Before you create coverage report, please make sure you have entered the following information in the system:

• Your NPI and organization name under Settings <  Organization
• Your client's name and date of birth under client details and demographics
• Insurance for the client including Insured Id

Refer to this article to set up all information needed for billing, insurance and claims.

There are 2 ways to verify insurance coverage on TheraPlatform:

Option 1: You can manually verify insurance coverage (by clicking buttons in TheraPlatform)

Option 2: You can automate this process with our auto insurance coverage option and specify when TheraPlatform should automatically run coverage report (e.g. every month, every 7 days, etc.).

Here are directions on how to manually check insurance coverage:

To verify insurance and create coverage reports follow these steps:

Step 1: Navigate to Clients and select a client by clicking on View icon.

Step 2: Under Client Details click on Insurance.

Step 3: Click on the green edit icon to open insurance details.

Step 4: At the bottom of the pop up- box, click on Check Coverage button to create coverage report.

Step 5: If the payer offers coverage report, the report will be added under Coverage Reports button at the bottom of the page. (Generating reports may take a few seconds).

Step 6: Click on the Coverage report button to view the report.

Note: If insurance does not offer this automated coverage verification- you will not be able to generate this report.

Here are directions on how to set up automatic insurance coverage report:

Step 1: Click on Settings

Step 2: Click on Billing

Step 3: Click on Settings

Step 4: Scroll down and under Insurance Coverage, mark in purple (toggle the switch on) Check Insurance coverage and select the frequency. Use the arrows under Monthly to switch to different frequency and on the... switch from First day of the month to any day you need. For example: a) monthly (on what day of the month, e.g. on the first day of the month) , b) daily (you can select number of days, e.g every 7 days, etc.)

Step 5: Click on Save changes

Here are directions on how to access/view  insurance coverage report: (after you sat up the above under Settings)

Step 1: Click on Reports

Step 2: Click on Billing < Claims < Coverage

Step 3: Under Coverage, you can filter the insurance coverage by:

• Client's name: start typing the name of the client under Search clients search bar.
• Status: click on the arrow pointing down under All search bar.
• All: this filter will show clients with both active and expired insurance
• Expired: this filter will show clients whose insurance is expired (not active)
• Active: this filter will show clients whose insurance is active.
• Payer: you can filter coverage by payers.
• Date ranges: click on the icon of calendar under Date From and Date to.
• Updated: Select the date by clicking on the icon of the calendar to see coverage report updated on that date.

Note: Under the client's chart and insurance, you will see a column "Coverage" , where we show different messages depending if you run coverage report or not:

• Coverage Not Checked message - means that no insurance coverage was run manually or automatically
• Expired message- means that the coverage report was run and your client's insurance is expired (not active)
• Active message- means that the coverage report was run and your client's insurance is active.

Related Articles:

Adding insurers (health insurance) to your practice

Adding insurance to your client's account