How to Add or Reset Insurance Policy Visits

To update the number of visits allowed by the patient's policy, restart the visit count, or to adjust when the visit count starts for the patient, follow the steps below.

Note: If you choose to enter insurance policy dates as an authorization on the patient's case as a workaround to be alerted to expiring insurance plans, you may experience performance issues when loading the Ending Authorizations report. This occurs when a large volume of authorizations expire during the same timeframe (i.e. at the end of the calendar year). For better performance, consider using the Authorizations Analytics report.

  1. Navigate to the patient's chart and select Patient Info.
  2. In the Insurance tab, click the Edit icon.
  3. In the Edit Insurance window, use the Next button to move to the Policy Information section of the Edit Insurance screen.
  4. Input or update the Visits Allowed box for accurate visit count reporting on the patient’s case(s).
  5. Add or update the Policy Dates.
  6. Include Copay/Coinsurance and Deductible information as applicable.
  7. Use the Next button to confirm guarantor information and select OK to save.

Reset Policy Visit Count

To reset the visit count for the patient, follow the steps above then turn on the Visit Reset Date field by selecting  Yes. Choose the date from the calendar. This field will start counting visits against the insurance policy on and after the date entered. For example, if it's 12/15/2018 and the patient's policy resets on 1/1/2019, you should only add the visit reset date of 1/1/2019 if the patient does not have an appointment between 12/15 and 1/1/2019. Otherwise, any visits added during this time will not be counted. Only visits occurring on or after 1/1/2019 will count towards the patient's visit count total.

Tracking Insurance Visits Example

  • Patient: Ernesto Vega
  • Allowed Visits: 30
  • Policy Reset Date: 5/1/2019

Note: When using a Visit Reset Date, visits counted toward the policy are tracked in the Ins Visits tracking field.

  1. Ernesto has an Initial Evaluation that was performed on 2/2/2019. He has 14 more visits before the policy resets.
  2. On 5/1/2019, the insurance visit count resets to zero. We then updated the Policy Dates to reflect that Ernesto renewed his insurance policy.
  3. Over the next three months, Ernesto is seen 25 times.