Adding Workers Comp Insurance

Here are the steps to creating an workers comp insurance company in HENO

Billing Tab > Insurance

Then click on "New".

RED: Add the name of the Insurance Company

ORANGE: Set as Procedure or Flat Rate reimbursement

YELLOW: If it is a Flat rate enter the amount there. If you receive two different flat rates, Eval and non-eval, enter the smaller amount.

GREEN: Set the Billing Guidelines which would be stated on the Website or in your contract

LIGHT BLUE: IF this insurance company requires an auth please change it to "Yes". If not please let it be as it is.

PURPLE: Enter the address that the claims that will be sent to.

Then Click "Create Company"

Set Rules for the insurance company and click apply changes

a. RATE RULE TYPE: If it is a company that needs G-Codes, move "G-Codes" into the right box. If you only want certain codes visible for this company, move "Listed Codes Only" into the right box and add codes into the Company Rates Tab

b. EXCLUDED BILL AS PROVIDERS: If there is a therapist that is not credentialed with this insurance company you can move there name over to the right box so that they don't accidentally be put as the Bill As Provider

c. Documentation: Select Work Comp Template

PINK: Leave set as "Practice"

ORANGE: This can be left as the default

TAN: Leave as the default

GREEN: Set to the desired Submission Method. Most insurance companies can be set up as EDI unless they are WC or NF

LIGHT BLUE: If you set to EDI, please choose a payor ID from the list

DARK BLUE: Enter set number days until you want the claim to populate on the No Response Report if you haven't received anything from the insurance company

Lilac: Such as Overriding your billing address. Please email support@heno.io for more information

GREY: Additional Options for 1500 form

Click Company Rates - this is where you would enter the CPT Codes that you want for your Listed Codes Only that you set in the Rules Tab (if you set it that way). This is also where you would enter CPT Codes for Medicare that have the GP Modifier attached to it.
Click Add Rate

RED: Choose Code

ORANGE: Enter Rate

YELLOW: Enter the Allowed amount if you know it (optional)

GREEN: Add GP Modifier (If needed)

PINK: Click Create

Repeat for all CPT Codes

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

Click Plan - You can have multiple plans under each insurance company

a. It will create a plan for you

b. Click the plan name to go into plan

c. You can change the name of the plan if you want

a. Let the system know if the plan requires an Auth or not. If no Auth is required then leave the check box empty.

b. Below that you are going to enter the claim address. If it is the same as the Company then enter the same address.

Click Advanced

a. If it is Medicare you need to have the G-Codes set to YES and PQRS to YES

b. Put checks in the 2 check boxes below that

c. Click Apply Changes

Click Plan Rates

a. 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 workers comp insurance is now set up. If you have any questions, please email us at support@heno.io