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Create IV Request
Admin Panel
IV Requests Reports
Create IV
IV Checklist
Insurance AR
Personal Injury AR
Create IV Request
Appointment Type
New Patient
Reactivation
Reverification
Patient Name
DOB
Insurance
Clinic
Appt Date
Appt Time
Treatment Plan
Status
New
Pending
Approved
Denied
In Progress
Completed
Services
Hold Ctrl/Cmd to select multiple.
Service Packages
Reassessment #
Post X-Ray
Insurance Reassessment #
Insurance Reassessment Fee $
Notes
Urgent
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Submitted Verification Requests (Filtered by Creation Date)
Created After
Created Before
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IV Requests Reports
Urgent (All)
Yes
No
Appt Start Date
Appt End Date
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Create IV
Patient & Policy
Coverage Details
Authorization & Notes
Request ID (From original request)
Insurance Type
Primary
Secondary
Verification ID
Patient's Name
DOB
Insurance Holder
Yes
No
Name of Insurance
Insurance Holder's DOB
Policy #
Group #
Effective date
Term Date
Plan Year
Calendar
Fiscal
Network Status
In-Network
Out of Network
Chiropractic Deductible
Yes
No
Individual
Family
Out of Pocket
Yes
No
Individual
Family
Co-insurance
Copay Amount $
Exclusions
Limits
Covered Codes
Hold Ctrl/Cmd to select multiple.
Prior Authorization
Required:
Yes
No
Completed:
Yes
No
MNR Required?
Yes
No
Website/Representative
Reference #
Notes
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Submitted Verifications
Created After
Created Before
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IV Checklist
Verification Request ID
Verification ID
Patient Name
Date
Sign off
New Insurance:
New Insurance:
Call the insurance company to verify or verify on the web. Complete all spots on the verification sheet.
Complete Chiropractic Insurance Verification Sheet.
If authorization is needed, stop and check if all authorizations have been submitted. If not, submit
Authorization Required:
Y
N
YES, Update Authorization Tracker Accordingly
Use insurance verification sheet to update patient insurance tab "patient information- insurance tab"
Add insurance (make sure address matches the back of the card for claims to be sent)
All commercial Cigna bill ASH (American Specialty Health)
Medicare
Fill out ABN form for Medicare patients
Make conditions tab acute manifest (453)
Policy Information
Coverage type = other (all insurances), Medicare (Medicare) (Red Box 1)
Insured ID (Red Box 1A)
Policy Authorization # (Red Box 23)
Insured's/other insured's information (this should be copied over)
Patient Responsibility
Copay
Insurance Percentage = insurance co-insurance
Deductible; deductible left
Visit Max Allowable for Insurance
Effective date
Term Date - if none make the end of the year.
React with Insurance:
Verify patients insurance following the same steps as above
Update patients insurance tab.
If there are existing policies in the insurance tab from a previous year, make sure all boxes are unchecked, an accurate termination date has been imputed, and then hide the policy.
If there are existing policies in the insurance tab from the current year, confirm policy information and update accordingly. Make sure any authorizations are up to date and accurate. If not, submit authorization asap.
Enter in policy effective date, according to actual policy dates (not rof or react date)
Current Authorization (if applies)
Update begin date to first insurance visit
Update end date per authorization
Enter number of visit max in second box
Option Boxes
(all 3 should be checked for electronic claims)
Paper claims (only select batch claims box)
Annual Limit
Annual visit limits update (if applies)
Amount max limit (if applies)
Patient Information:
Change to the appropriate fee schedule and case type in patient info
Review codes in ledger for React appointment. Make sure codes are accurate (cash codes if they paid cash and specific insurance codes if they paid allowable and payment reflects patient responsibility).
If medicare, update conditions tab modifier with react appointment date.
Change Primary Provider = Clinic being seen at
Billing Provider = Appointment Provider
Complete Financial PPW
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Submit Checklist
Submitted Checklists
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Created Before
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Insurance AR
Create Insurance AR Request
Manage Insurance AR
Create Insurance AR Request
Patient’s Name
Patient's DOB
Member ID
Clinic
Date Of Service
Insurance
Claim ID
Request Status
New
Pending
In Progress
Completed
Notes/Instructions
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Submitted Insurance AR Requests
Created After
Created Before
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1. Find Claim Details
Date After
Date Before
Claim Status
All
Pending
Denied
Paid
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Results
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2. Create/Edit Follow-up
Patient:
DOB:
Insurance:
Claim ID:
Claim Description
More Details
Claim Reprocessed?
Yes
No
Claim Status
Pending
Denied
Paid
Submit Follow-up
3. Follow-up History for this Request
Refresh History
Export History (PDF)
Personal Injury AR
Create PI A/R Request
Manage Personal Injury AR
Create PI A/R Request
Patient’s Name
Patient's DOB
Date of Injury
Clinic
Follow-Up Frequency
Next Follow-Up Date
Total Billed Amount $
Claim Number
Attorney Contact Information
Request Status
New
In Progress
Closed
Notes/Instructions
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Submit PI AR Request
Submitted PI AR Requests
Created After
Created Before
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1. Find PI Claims
Date After
Date Before
Claim Status
All
Pending
Paid
Patient Responsibility
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Results
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2. PI Update
Patient:
DOB:
DOI:
Claim #:
Section 2: PI Update
PI Update Description
Call
Email
TCP Update
Correspondence
Phone Call
Payment
Reduction Request
Dropped by Attorney
Claim Status
Pending
Paid
Patient Responsibility
Submit PI Update
Follow-up History for this PI Request
Refresh History
Export History (PDF)
Edit History
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