Using the general Provet Cloud insurance claim function, you can create insurance claims and send them by email to the insurance company. If required, you can also print insurance claims and send them by post.
To use the insurance claim functionality, some additional setup is also needed.
For assistance with specific insurance company integrations, contact Provet Cloud support.
1. Create and send the insurance claim.
- Open the invoice you want to create an insurance claim for.
- Select the + Claim button. Depending on the insurance settings, adding insurance claims may be possible for finalised or draft invoices, or both. If the claim button is not available, check your insurance claim process with your clinic administrator.
- Check that the correct Patient is selected and select Claim type (General for an insurance claim which will be sent by email using the Provet Cloud general insurance claim function). Then select the Select button. The Create insurance claim dialogue opens.
- In the Client and Patient sections, fill in all relevant information. If an insurance company has been saved in the patient's information, it is automatically added to the Insurance company field. You can also update any client or patient information and select the Update client and Update patient checkboxes to save the information to the client's and patient's records.
- In the General insurance claim section, you can add a message to the insurance company. The insurance company contact email set in the settings is added automatically based on the insurance company selected in the patient details. If you do not have the case number yet, you can add it later.
- In the Attachments section, add any relevant attachments, such as the invoice and patient history. From the Data for patient history PDF drop-down list, you can select whether to add the patient's whole history or only data from the current or selected consultations to the patient history PDF file. Attachments added on the client page's Communication tab are available under Attachments linked to the patient, and you can also upload additional attachments.
- Select Create to save the insurance claim. If you want to include all invoice rows to the claim, you can send the claim directly by selecting Create & send.
- After saving the claim, you can select specific invoice items for the claim. Select the pen button on the insurance claim row to open the claim. In the Select invoice rows section, select the Select invoice rows button and then select the blue arrow button to view the list of invoice rows. Select the rows you want to include in the claim and then select the Select rows button.
- When ready, select Send as email. If you want to send the insurance claim by post, you can print it after saving. Then change the insurance claim status manually to 'Sent' by selecting the small arrow next to Send as email > Mark as sent.
2. Update the claim based on the insurance company's decision.
When you have received the insurance company's decision, update the insurance claim information.
2.1. Find and open the insurance claim.
All insurance claims are listed on the Clients & Patients > Insurance claims page. You can search using the text search field (1) or use the filters (2) to limit the list. To open an insurance claim, select the pen button on the row (3).
You can also open an insurance claim from the invoice page. Go to the invoice page, scroll down to the Insurance section and select the pen button on the row. You can find invoices through different places in Provet Cloud:
- Dashboard: Invoices are linked to consultations under Recent consultations.
- Client page > Billing tab: Lists the selected client's all invoices.
- Clients & Patients > Invoices: Lists the invoices of all clients.
2.2. Update the information and mark the insurance claim as 'Ready'.
In the General insurance claim section, add the Case number and Compensation sum. Remaining sum for client shows the amount the client still needs to pay after the insurance compensation.
Change the Status of the claim to 'Ready'. Note that depending on the insurance settings, the insurance claim status may have to be 'Ready' before you can finalise the invoice and select the insurance claim payment method for the invoice payment.
2.3. Save the information.
Select Save. After saving, the invoice shows the amounts to be paid by the insurance company and the client.
3. Add the insurance payment to the invoice.
- Finalise the invoice if it has not already been finalised. Scroll down to the Payment section and select the + Payment button.
- In the Paid field, add the sum paid by the insurance company. Depending on the insurance settings, it may be possible to add a partial insurance payment or the payment may have to match the full insurance compensation sum.
- From the Payment type drop-down list, select Insurance claim.
- Add any additional information and select the green check mark button to save the payment.
Insurance Claim Statuses
- Created: This status is assigned automatically when an insurance claim is created, but not yet sent.
- Sent: This status is assigned automatically when an insurance claim is sent by email. The status can also be changed manually to 'Sent'.
- Waiting for info: You can select this status manually after sending an insurance claim to indicate that you are waiting for information for the insurance claim.
- Ready: After receiving the insurance company's decision and updating the information on the claim, you can change the status manually to 'Ready'. This status is not assigned automatically.
- Rejected: You can change the insurance claim status manually to 'rejected' if the insurance company rejects the claim. The status is also changed automatically to 'rejected' when an insurance payment is refunded using the credit note function.
- Ready, paid: This status is assigned automatically when the insurance payment has been added to the invoice.