HMO & Insurance

Manage HMO enrollments and insurance verification.

Overview

Register patients under HMO plans, verify coverage, and track claims.

Features

• HMO Plan Management — create and manage HMO plans with coverage details
• Patient Enrollment — enroll patients under specific HMO plans
• Coverage Verification — verify patient coverage before treatment begins
• Claims Tracking — track submitted claims and their approval status

How It Works

1. Set up HMO plans in Facility Settings with coverage details and limits.
2. When registering a patient, select their HMO plan if applicable.
3. During billing, the system verifies coverage and applies HMO rates automatically.
4. Claims are tracked and can be exported for submission to the HMO provider.

Tips

• Verify coverage before starting treatment to avoid billing disputes.
• Keep HMO plan details updated to reflect current coverage limits.
• Use the claims report to reconcile payments with HMO providers.