rmathieu wrote on Tuesday, September 22, 2009:
Is there a setting anywhere for insurance coverage and how can we set it up.
sunsetsystems wrote on Tuesday, September 22, 2009:
Not sure what you are asking. Be sure to review the Users Guide (click Help at the bottom of the navigation area in OpenEMR), then if necessary ask a more specific question.
rmathieu wrote on Tuesday, September 22, 2009:
If for example, a patient got only 80% coverage instead of 100% coverage, I don’t see an option where I can put the coverage purcentage.
This is important because certain insurance company covered only 60%, 80% of the fee schedule.
Is there a setting to enable this function?
sunsetsystems wrote on Tuesday, September 22, 2009:
Nope. But that’s an interesting topic and I’ll be interested to hear from others about it.
For what it’s worth, as a patient I’ve never been asked up front to pay a percentage or deductible, just the co-pay. I think most doctors have given up on trying to figure out what each payer will cover, and just wait for the EOB and then bill the balance.
bradymiller wrote on Tuesday, September 22, 2009:
hey,
Small clinics (usually alternative medicine that take insurance, but cash flows aren’t nearly as big as mainstream clinics) sometimes attempt to collect deductibles and percentages not covered at time of service so they don’t lose money on attempting to collect bills. Considering OpenEMR is low cost I’m guessing its use will also increase in these types of clinics. So, this would likely be a useful feature to have.
-brady
rmathieu wrote on Tuesday, September 22, 2009:
Actually, we have 5 clinics that need to collect the uncovered insurance costs at the time of visit. This is something we really need. Could you easily add the new field so we can enter the insurance coverage percent? How would the billing be adjusted so we can include the uncovered costs?
docaltmed wrote on Tuesday, September 22, 2009:
Yes, that would be me, the Center for Alternative Medicine. We collect deductibles and %-based copayments at the time of visit. A method to calculate that would be handy indeed.
Avery
seaneburke wrote on Tuesday, September 22, 2009:
Yes our birth center here in Salem, Oregon also try to collect percent-based copayments either up front and/or finance it in-house. A field to enter the percentage covered that is used to calculate the copay would be truly "spiffy"! 
ideaman911 wrote on Friday, September 25, 2009:
Timely question. My wife (Most important client 
just asked a similar. And as it turns out, there IS a capability just introduced with ver 3.1.0. In the Admin - Layout - Demographics you can now move any field to anywhere AND most importantly select it to have an ADD function right there with "text w/ add". So choose an unused "User Selectable List" and give it a name, and then you could put the specifics, right down to "$120/yr OOP then $1200 at 80% from Pt OOP, then other at 20% from Pt" which would give you a pretty good idea what to collect at the visit.
As you add or update a patient, you can check the listing, and add another if one is not found which describes that person’s situation. Of course, someone at your clinic would have to have the Cray computer to figure it all out, and the "interconectivity" the dreamers believe will happen "soon" so you could know how much of each threshold had been "claimed" so far. I would not hold my breath awaiting that sophistry.
Just a thought, requiring no new coding. My plan for the time being.
Joe Holzer Idea Man
http://www.holzerent.com