Insurance Company Set Up

Here are the steps to creating an insurance company in HENO

  • Billing Tab
  • Insurance

  • Click "New"

  1. RED: Add name of Insurance Company
  2. ORANGE: Set as Procedure or Flat Rate reimbursement
  3. YELLOW: If it is Flat rate enter the amount there. If you receive two different flat rates, Eval and non-eval, enter the smaller amount.
  4. GREEN: Set the Billing Guidelines which would be stated on the Website or in your contract
  5. LIGHT BLUE: Set the insurance category: ie. HMO, PPO, Medicare, Medicaid, ect
  6. PURPLE: Prompt om Guidelines: If Yes will prompt the user if to few or to many codes have been entered based on AMA vs. Medicare Guidelines.
  7. PINK: Payer Scenario
  8. BROWN: Enter in the claims address.
  9. Select "Create Company".

Set the Rules & Excluded Bill As Providers (If selected that provider will not show up as an option for this insurance company) for the insurance -> Apply Changes:

Claims Tab

  • ORANGE: Set how you will bill claims out 
  • GREEN: Set Filing Indicator
  • BLUE: Set AOB
  • Set your Submission Method for claims. If set to EDI, Select Clearing House & Payer ID.
  • Apply Changes

Company Rates Tab

  • Add rates

  • RED: Select procedure code
  • PINK: Select Rate
  • GREEN: Enter Allowed amount
  • BLUE: Add Modifier if needed 
  • Create

If you have other insurance companies with similar Company Rates you can lick the Copy Rate Button:

Choose the insurance company that you want to copy it to. You can choose a plan to copy it to as well but that is optional. Then Click Submit

Plans Tab -> Create a Plan (if you have multiple plans under an insurance company)

Enter in the Plans information ->Create:

Select Advanced:

  • If it is Medicare you need to have the G-Codes set to YES and PQRS to YES
  • Put checks in the 2 check boxes below that
  • Click Apply Changes

Select Plan Rates: 

  • This is the same as the Company rate. If there are different rates for the plan from the company then enter those rates here.

Your insurance company is now set up. If you have any questions then please email us at support@heno.io