Mastering Insurance Billing with Jane | Save Time AND Get Paid Faster

Hey everybody. I am lucky to be sitting here with Amy from Jane. We're going to talk insurance. Insurance has been a big question in the EHR world and how your EHR and EMR can process insurance based payments and collections can make a world of difference in the efficiency of your practice. So we're going to take a few moments today and show you inside of how Jane has made massive advancements in their ability to systematize insurance collections in your practice. So with that being said, Amy, I'll ask you to kind of take it away here.

Amazing. Thanks so much for having me. I'm very excited to talk with you about insurance. We definitely have made some new changes over the last year or so that I think are going to be pretty exciting. So we do have now a direct integration with ClaimMD as a clearinghouse. We do work with four clearinghouses, Availability, Trizetto, Office Ally and Claim MD. With ClaimMD being that direct integration, no downloading, no uploading, which if you were familiar with Jane in the past, was how we dealt with clearinghouses before. The other really cool piece about that is that with that direct integration with Claim MD we now have eligibility checks, which I'm excited to show you what that looks like as well. And we also have added the ability to collect more insurance information in your intake paperwork. So we used to be primary policy only and then if they had secondary, they'd be bringing that to the appointment with them. And now we can actually collect that primary and secondary all at on the intake form, which is really cool. So one of the first key things I want to show you speaking about intake forms is what it looks like in Jane when you have a pending policy. Because I think this is probably one of the largest questions I got in support was how will I know if they've been, if they've actually sent me their information? Well, let's take a peek at what that looks like. So on my screen right now I am in Greta's appointment. She's a new patient. This is her first time coming to see me. And you're going to notice over here I've got a notice as an action item section. This does not normally appear on the appointment panel. It only comes up when I have a policy that needs to review. It will also warn me if coming close to policy maximums. So it will be a bit of a, oh, jarring thing to see because you won't normally see it. So but it's basically letting me know that she has Aetna and that she submitted the policy and Then it's giving me an option to review it. When I click on the button, it's actually going to overlay the policy information right over top of the schedule. So it's not taking me somewhere else. I can do a bunch of things right from this screen, which is kind of nice. So you're going to notice I've asked her to give me the front and back of her insurance card. This is just a card I uploaded from Finding Google. Yay. But one of the cool things I wanted to show you is that we can check eligibility from here. We can also edit this information. So if I notice, say that she has typoed her policy number compared to what is on the card, which is why it's so important that we get these pictures, I'm able to go ahead and go in and change it. Also behind our edit function is a whole bunch of other really great info. So for example, we can have an internal name for each of the policies. The easiest use of that is primary, secondary. But there's other times that we may want to include some extra detail that is just for our eyes only. We can also put in information such as those policy maximums and wonderful stuff. So after we pull that, that eligibility check or if you are with an insurer who doesn't currently provide electronic eligibility, so after you've made that phone call, you've got places to put in all the information that you're to need, also including things like current date of illness or injury, was it related to an auto accident? All of that wonderful stuff lives on our policies. And this is where Jane is pulling all the information from when we're, when we're creating claims, which is awesome.

That is great. When somebody does a digital eligibility check, how long does that typically take?

We're going to do one right now. I'm going to show you. It's just going to be some sample data, but I'm going to show you how quick it is, which is really wonderful. So I can go ahead and come down here and I can hit my Start an eligibility check. Or you'll notice I had a button up here as well. So if I click start an eligibility check, Jane's going to bring up a form. It's going to ask me what am I looking for. So I'm going to go by. Right now our default is health benefit plan coverage. But you can choose default. Now the, the one thing I will tell you, I will choose chiropractic here. But our sample data just brings me back health, general health information data. But I wanted you to see how quick the process is. I'm going to change it to the location I created and that'll get rid of that little error we had up here because you have to have the correct. So your NPIs and your. And your tax ID are registered. Registered with ClaimMD at the time. And that's what's pulling eligibility checks. So you can pull it from a type 2 NPI. So your clinic NPI or individual NPIs as well. Awesome. So we come down here, we go ahead and we click our submit check, and then ClaimMD is going to send me back some fake little data, but that is how fast that happens. So it's going to give you anything around information around deductibles, maximums, all of that wonderful stuff. You're going to be able to see it here and reference it at any time.

That looks absolutely fantastic. Is your recommendation for best practices that docs do this yearly and then, of course, whenever a patient's insurance changes or. What would be your recommendation?

You know, I would definitely say that checking eligibility. We definitely have people who check eligibility. Let's say they have those casual patients that are coming in, you know, if they're on a treatment plan and you know they're coming in, like consistently, you can kind of hang on to that coverage unless they tell you it's changed. But if somebody comes and sees you kind of occasionally, we do have a lot of clinics that check it only almost every time they see a patient, if they haven't seen them in a while. The other thing that I would say is absolutely, when that coverage renews annually, do another check, because some things may have changed. You're also able to reset these policies back to zero. So if the maximums and things have not changed, Jane will actually just create. Close out the old policy, create a new one and just refill all those maximums for you, which is really great. And then if they have changed, you're able to renew that policy, make any changes you need to based on the eligibility check, and then move forward with that. But yeah, definitely yearly, definitely before the appointment. If, if there's one thing I can. If you have a. For a first appointment, you know, being able to have that really meaningful conversation about what their coverage is and what charges and things that they could expect to incur, you know, ideally prior to their first initial appointment, or at least you've pulled the information so you can have the discussion face to face during the initial appointment is definitely key. Absolutely amazing. So now that I've gone ahead and Edited this. I'm going to save and approve this. So it's going to move it out of that needing state to being to now. It's been reviewed a couple of other key things you can add in things like default billing codes as well, which every time you attach the policy, the default billing codes will follow. Jane gives you at least three, I'm going to say three solid ways to get those billing codes onto your appointment so that you can bill claims. One is through the default coverage here. You can put it on the appointment panel and you can also chart them as well. So let's go ahead and hit save and approve. I can go ahead and close that out. And again, I'm right back where I started. I'm able to go ahead and arrive this appointment. But first thing I'm going to do is just add in my now approved policy. So now I've gone ahead and added her Aetna policy in and you'll see here on my billing info it's generated a claim. Okay. One of the key things would be if there was a copay that I, that I was aware of, I could enter it on the policy and it can also be entered on the appointment panel like I'm doing right now. And when I do that, you're going to see the changes to the billing here. Key thing about this, because I find people always worry about this when I once I go ahead and change this. If the total value of the appointment is $100, you'll notice here it says Aetna is 80. Jane will always send the total value of all of the billing codes. The entire $100 worth of billing codes is what Jane is actually going to send. This is just for record keeping, right? It gives you a better idea. Like you know that they paid you the $20 at the time of service, so you're assuming you're only going to get paid on the remaining 80. Whatever Aetna is going just gives you a little bit more of a realistic AR when you're looking at your reporting.

That makes sense. That's a great feature.

Awesome. So once I've gone ahead and arrived at I can go ahead and pay that my copay. And you'll notice that my Aetna is now sitting in an unsubmitted folder. So our folders are where we do all of our claim submissions and claim reviews on and those live under the billing tab. And we're going to head there in a moment. But I did want to mention too what it can look like if we have More than one policy. So here I've got a Blue Cross Blue Shield policy. Medicare is rarely secondary, but this is our demo clinic. So just showing what this would look like. Once I've added two policies, what will happen is, is our primary policy and actually Medicare is a really good example of this. When you're setting up Medicare with Jane, there is a little button that basically says that your primary is going to submit to your secondary for you. So it's, it simplifies that whole submission process for primary and secondary claim. When Medicare is primary, then for let's say Aetna and Blue Cross, what will happen is the primary claim will go to the unsubmitted folder and the secondary claim moves to a waiting on primary folder. So basically what we're going to see is once we have submitted our primary claim, it goes off, gets adjudicated, comes back to us, we process that era in Jane, update all the information about what they paid and then anything that wasn't paid automatically gets pushed to the second payer. Now that claim that was sitting in the waiting on primary folder now moves to our unsubmitted folder with all of the explanations about what the primary paid and did not pay. So very important. Ideally, if we can attach our secondary coverage at the primary stage, all of that information follows over, which is fantastic.

That's great. Yeah. And I want to just reiterate one really, really important, important point that you just made and that's around not having to, when you set it up appropriately from the get go within Jane, you're not going to have to chase down all of these secondaries, but it really facilitates your ability to get paid. And we know there are so many patients coming in now with all different types of insurances and secondaries and add ons. So being able to get things set up from that patient's first visit saves you and your team a ton of time and money of having to figure things out and chase things down, which are some of the biggest costs associated with running a practice. So Jane, I love what you showed here Amy, because Jane has made it super, super easy. When you set things up in the proper way to begin with, everything else can really be taken care of for you and it does the math right. I know as much as provider like oh my gosh, the math can become difficult. I didn't sign up for math. Jane makes it so easy for you to be able to rectify your accounts receivable, understand who owes what and when and really just I think of it almost like an Old game, right where you put the domino in the top and it goes down, you know, you know, to, you know, to the prize at the bottom. So in the event that somebody has multiple insurers, you can start the process on that visit. And as you just went through in detail, which is awesome, now Jane takes that ball and runs with it. In other words, it really gives the opportunity for the first payer to make the payment, transition the, you know, whatever's owed to the second payer without you having to do anything, and it all rectifies again back to that original charge. So I just want to make sure that's hyper clear for everybody listening and watching. Because chasing down secondaries, or even worse, leaving payments, money on the table because it's such a pain in the butt is a real cost for so many practices. And Jane makes it easy. So sorry to get you out of your flow there, but I wanted to make sure we just came back around and touched on that.

No, that's all good. And actually it brings me to a really great point. So Jane, Jane actually has on staff US billers, and they have been absolutely instrumental in like, I think we've always had really strong customer support, especially around our US billing, but now we have that extra piece. So if you're thinking of starting up with Jane, or if you have been with Jane for a while and you want to make sure that you are using the absolute best workflows that you could in Jane for your insurance billing, we are here to help you for that with that. So we can actually do account setup, consultations specifically for insurance with our billers if you're new to Jane, and then we can draw on their knowledge. If you're currently a Jane customer and you're like, geez, I'm wondering if I could make this better. The answer is probably yes. And that we can absolutely help you get there and make sure that you're, like you said, not leaving money on the table because that's so very important or giving yourself more work than you need to.

That's awesome.

Awesome. So one of the key things, I'm going to go ahead and pop back to Greta's and I'm just going to go and add in my, my billing codes. I'm going to grab my 98941, say that she's got some pain, and then I'm going to grab my okay and I'm going to go ahead and grab my initial exam and that's going to pull my, my code down. Now again, I threw that right in on the panel. Another key thing about this, when Greta comes back for her follow up subsequent visit, I'm actually going to be able to, when I book the appointment, ask Jane to pull those codes into the new one and then I can remove like. So let's say if I do have that initial exam in there piece, which is quite often not covered by insurance anyway, I can just remove that and then just keep in my adjustment codes and that type of thing. And then every time I book a subsequent appointment, I can just keep pulling that information over. This also works when we are charting codes. Every time you duplicate a chart note, Jane is going, if there's codes in your chart note and codes on your panel, Jane is just going to keep reminding you, hey, these match. Or if for any reason you change a code, it's going to tell you, hey, these don't match. So that you can make sure that you're billing accurately all the time.

That's great.

Amazing. So I went ahead and threw those in and I've gone ahead and arrived that appointment and now I want to go take a peek at our billing folder so we can take a look at what the process looks like from a submission and reconciliation standpoint for remittances.

Sounds good.

So my billing folders over here, my claim submission folders start with the add draft folder. By default, we have new claims start in the unsubmitted folder. But this draft folder exists because if you're working with something and you're like, I need to dive a little bit more into this, you can move it from your unsubmitted to your draft and just administratively have a place to keep that. Another key thing that I think works really well, especially if you have either an internal biller or an external biller. You can actually ask Jane to have all of your claims start in the draft folder, which means you know that absolutely no one has looked at those claims that are in the draft folder. They've basically just been created. And what you, what your biller can be looking for is things like this where procedure and diagnosis codes accidentally weren't added in and then they can be corrected here and then moved en masse into your unsubmitted folder, which is where you submit your claims from. So ideally, you wouldn't want to see anything like this in your unsubmitted folder if you're doing a workflow where you're starting in draft. So Jane gives you that option. Really great. From a process standpoint, one of those things, not a lot of people know, so something I like to throw out there because it can be really helpful. Within our unsubmitted folder, you'll see that we have lots of different options to be able to filter this data. So again, this comes down to workflows and best practices and you can reach out to us for these as well. So we definitely want to make sure we. We have added in chart status. So chart status is actually a, a new field within this report. This is something else that has been added relatively recently because ideally we're wanting to send in our claims for our signed chart notes. Right. Which means that you're actually able to filter this from the top. So you can make sure that you filter it by just your signed notes and then you can go ahead and say, okay, I want to make sure I'm only sending my ones with signed notes and I only say want to send my Aetna claims. I also have the ability because you'll notice we've got some secondary badging on here. So primaries have been recorded and these secondaries are now in my unsubmitted, getting ready to send. But let's say I want to just. I just want to send my primaries right now. So you're able to filter this including right down to a date range to make sure that as you're going through the submission process, I'm definitely one that likes a really good process. So being able to send like buying insurer is great. You don't have to do this. You can just quite literally say everything that's in here go. But it's kind of nice sometimes from a process standpoint, from an administrative standpoint, to be able to do these filters, which is great.

Sure.

Once I've gone ahead and I've clicked on some claims that I want to submit, I go ahead and hit my submit selected claims and we're going to our. We call this our pre flight checklist. So Jane, before it even gets to the clearinghouse, Jane is looking for some really key things here. Does the patient have a date of birth on file? Did that get missed? Oops. Jane's going to put a big red banner on here if you're missing a payer id, if any of the. If it doesn't have any billing codes or ICD10 codes, Jane is going to stop it from even leaving. So you'll never accidentally be able to submit a claim to the clearinghouse that doesn't have at least those key pieces. Okay. When it does have everything it needs, Jane's going to say this claim is Ready to go. And if there were any in this batch that did have a red thing, you could, you could safely submit all of your ready to go claims and Jane will just leave that one that wasn't ready to go in your unsubmitted folder so you can fix it up. Once I go ahead and click this hit this generation of claims off it goes to claimMD. So if you're doing the, if you're doing the direct integration, this goes off directly to ClaimMD. Then ClaimMD will send it out to your payers and you're just waiting for your eras to come back, which happens automatically. If you were using one of the other three clearinghouses that Jane does work with, you would download this file files right there, you would upload it into your clearinghouse. Again, same process, it goes off to get paid. But when you get those eras back, you're downloading and uploading them. So our claims have now gone ahead and moved to our submitted folder. So our submitted folder is basically a snapshot of everything that you have submitted for every insurer and you're actually able to. So down here we have a little search function. Down here when you're searching, you're searching all claims in all statuses. And this can be a really great tool for either your billers or yourself to pull information about, you know, where am I with my, with my claims, like have what's unsubmitted, what has been submitted, you know, and what dates were they, were they submitted on? Because you'll see you've got admission dates. So just a really great way to kind of pull snapshots. And of course you can also see all of your insurers have a profile very similar to a patient, where you can actually pull statements and things of where your claims are at and do of course, date ranges and all that wonderful stuff, right. Claim md. Also, if you choose to use our Claim MD integration, Claim MD has some fantastic reporting. So all of your claims that throw flow out of Jane through ClaimMD, you're going to be able to get some extra reporting information from them, right down to like, how many times have I built this billing code and that type of thing? Which is really fantastic.

That's. Yeah, that's really good.

Complementary to Jane's reports for sure. Excellent. So once our claims have gone off and gotten paid, they're going to come back to our remittances folder. So again, if you are doing a download upload, here's your upload button up the file goes and then it will show up Here, just like this. And then with claim MD as you are getting remittances. So as insurers are paying your claims, they're just going to start populating in here. Jane's going to tell you how many responses are included, who the insurer is, what, and a general overview of what they've paid you. Okay, we're going to go ahead and click our view button in the very first place we're going to start. Jane is basically going to ask you, okay, here's the insurer that paid you. Where are we putting this amount of money? So let's say in this case they went and paid you by check. Any information in this box up here is what came back directly from the insurer and Jane takes that information prepayment. So these are funds in Jane that we're ready to apply to our claim responses. Claim responses, very easy to review. So just by taking a quick look at it, we can see the total amount that was submitted, the total amount that was paid in any patient responsibility. When we click our view button, everything at the top here again is what the insurance company sent back, including all of our coding. So when we're talking about primary to secondary, it's these codes, you know, patient responsibility, contractual obligation, all of these things that, that are getting recorded so that if amounts are getting pushed to the secondary, Jane is recording that for you for the secondary. Okay. Jane takes all of this wonderful information and it pre populates it into Jane's version of the eob. So this is basically you reconciling by billing code what was paid and what the the patient responsibility is. Once I go ahead and hit apply changes. This is now an approved and paid insurer invoice. And now our patient has an unpaid invoice. Very cool new feature that is in beta. Now that I have gone ahead and approved and paid this invoice, tomorrow morning my patient will get an automated message letting them know that they have a balance. Your claim has been returned by insurance and there's a balance owing. Here it is. And here's a pay balance button, which is great. So they can pay that online.

Yeah, that, that, that's really important. And I'll just, again, I'll kind of circle that one just briefly and reiterate what you said. For everybody listening and watching, this is going to make your ability to collect money way easier in your practice. So if you are somebody who takes insurance, Amy's showing you how easy this is. And the nature of taking insurance is most of the time, most of your patients are Going to have some form of a bal. The automation of the collection of that balance critically essential because again, I think about the amount of time spent trying to collect this money is inordinate in many, many practices of small, medium and large size practices. And that challenge only gets, only gets increased the larger you become as, as a practice. So being able to automate components of that, and yes, if you need to make that outbound phone call, if you need to make a personal connection, yes, you can still do that, yes, you can still edit things, but being able to have that, at least that first touch point automated for you can pick up whatever percentage that might be of people who then go in that next day, they pay on their own. And that just saved you a massive amount of time. And as that continues, I'm going to say higher and higher adoption from the patient perspective, meaning paying online, it's only going to save you more time. So this is something that, you know, starting literally tomorrow in your practice, if you take insurance, being able to turn that on and enable your patients to rectify that balance without your team having to lift a finger can save you a tremendous amount of time. And as we always, I always like to say money has velocity. So, you know, you really don't want these balances being out for months and years sometimes we see that, that, and that's all lost money. And if you're delivering the service and if you're delivering exceptional patient care, you should be paid for it and this enables you to do that. And I love this feature. Amy, great, great work to the dev team.

Yeah, yeah, this was, this was one of those things where we saw an opportunity to be able to provide a real delight to, to, you know, practitioners and a way for you to not have to worry about, did I, did I go into their account and send. Because we absolutely have the ability to pull and send statements and those statement have a pay balance button on it. We absolutely have the ability on the patient profile to send a text reminder that you have an outstanding balance. So those things exist. Up until this point, we didn't really have an automation around them and of course pulling the AR report report and going through things as well. But we didn't really have a way to automate this. So this new feature we thought would be really delightful because it's going to send once, you know, it's reconciled and you know that that's what that patient owes, off it goes, which is really nice. It's a feature that you can turn on, off and it will live in the Notification setting where all of your text and email reminders live. So very cool. Awesome. All right, so key things that, that we touched on basically with our, with our new features. So you've seen like a very high level overview of, of what it looks like. Of course we do have the ability for you to be able to see things such as any rejected claims and why they've been rejected. So this one was rejected for missing information. So we are able to help you at Jane as well. Usually we can help you figure out whether this is something we, you can just easily fix in Jane. And if you're having trouble figuring out where that information needs to go, reach out to us. We can help you do that. Or it will let you know whether or not this is something you have to reach out directly to the insurer for. There are some times where you'll be sending in a code, especially if they have a secondary that might pay something the primary does. You might get that rejection from the primary knowing that it's going to be rejected, but that's okay because it's going to move on to the, to the secondary. So very cool features that we have and we again, probably one of the biggest things about Jane when it comes to any of this is of course you are supported. You're supported as you're working through setting, getting set up correctly to start billing insurance in Jane and you are supported if you run into any issues while you're billing in Jane. Jane.

Nice.

Fantastic. Was there anything else we wanted to cover here? Do we just want to dive into some questions?

I think this has, this has just been super great. So let's take a look, Amy, if you don't mind, of how this then fits into some of the financial reporting really quick. So let's just com complete the process together because I love how Jane has made it so easy for docs to get paid. So I know we're not going to do a deep dive into the reporting today, but I would just love to take a quick, quick peek into some of your favorite reports that reside within the billing because I think that'll bring it really full circle from treatment delivered, insurance paid, balance collected, to being able to check and ensure that you're getting paid on the back end.

Absolutely. Well, let's take a look at a few reports then. So our summary report with Jane is basically going to show us within a specific time frame what has been collected and what is still outstanding. So what our sales have been, what our AR has been. Quite often those, those won't match because we may have been paid today for an invoice that from three months ago. Like ideally it's faster than that, but it happens, right. So but this is a great snapshot of the information that, that you would need to sort of like do a quick health check. It also covers things such as your transactions and how your transactions so sales by location, your sales breakdown. So within Jane you're able to up what we call basically it's income categories. And our income categories allow you to have a greater control over how you review and report on your income. It also, if you are in a practice where you are paying people on a per percentage or commission based rate, your income categories can also handle that as well. But one of the, one of the coolest features of them that I think not a lot of people use. Even if you don't use Jane's compensation structure, the income categories can be a really awesome way for you to see to separate income based on type of service. Right. So let's say if you offer a piece of equipment and it's sort of separate from, from you so they'll, your patients will come and see you, but they might be able to book to go into like an infrared sauna or something of that nature. And you want to see how much money is just that one thing generating instead of out keeping the income lumped together. You can actually pull out the income for just that one piece by giving it its own income category, which is really nice. That is great. One piece by giving it its own income category, which is really nice. That is great. Yeah, you'll be able to see things such as any gift cards, if you do gift cards at all. Your where your income is coming from. So patient income versus your income sources as insurers and then things such as your transactions. So how are you collecting your money? Cash, check, all of that wonderful stuff. So this is one of my favorite reports because it's a natural nice kind of snapshot of all the things all at once. Pretty much everything you can see here is broken out into its own report under this billing section. So if you just want to see sales, you can just see sales. And of course we do have a transaction report as well. So the accounts receivable report, this one we actually have the ability to, to just do, just show our patient account. So if we're trying to follow up on patient ar, we're going to be able to do that from this report. And then if we want to just see our insurance accounts like, like how are we doing what's owing this like again a wonderful snapshot of like how are like our claims aging, what's going on with that and then being able to pop in again to the insurer profile and take a look and maybe reach out and find out what's going on with those things. But ideally, you know, it's overview snapshots within our AR reporting to make sure that again, you know who owes you and how, how old that balance is.

Well, this has been absolutely fantastic. Amy. I really appreciate you diving in and docs if you are looking to build more efficiency in your practice with your team and through the engagements that you have with patients every single day in your practice, I'm going to encourage you to connect with Amy and her team over at Jane, have a conversation. As you can see, they've just invested a ton in development to make your life life easier. So if you have been frustrated with your current ehr, if you're maybe moving to digital for the first time off of paper or you just know that there's better options out there, I'm going to say Jane is one of those options and probably at the top of the list. So we'll drop links down below. Please connect with the Jane team and Amy's team. Ask any questions that you have. They're awesome, they're happy to go through this. They love being able to show off off where they've put so much time, effort and energy to make your life easier. So Amy, thank you so much for coming on today and diving into insurance. This is a a topic that's important to a majority of practices out there and it's great to see all the tools and resources you have available for them.

Thank you so much. Thank you so much for having me. I was so glad to be able to go through it and like I said, we're all just as passionate about this, all of my colleagues are. So like you said, please reach out to us. We're happy to talk.

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