Configure & Manage Insurance Manager in Practice Settings – CareStack: User Resource Center

The Insurance Manager streamlines the creation of insurance carriers and plans with templates, reducing manual effort and ensuring consistency. With this tool, users can quickly populate required information, organize data in a structured manner, and generate standardized insurance offerings tailored to their needs. This not only enhances efficiency and productivity but also allows users to focus more on strategic decision-making rather than administrative work.

Let us explore how to configure different areas of the insurance manager via Practice Settings.

Let's get started!

Insurance Templates

An insurance template in CareStack is a pre-defined framework that helps streamline the process of entering insurance plan details for patients. It includes various elements such as benefit descriptions, procedure codes, coverage percentages, and eligibility rules.

By using templates, dental practices can save time and reduce errors when managing patient insurance information. Templates can be customized to reflect the specific coverage options and rules of different insurance carriers and plans, ensuring accurate treatment planning and billing.

Click here to learn all about Insurance Eligibility Settings.

Add Insurance Templates

Navigate to the System Menu > select Practice Settings > Insurance Manager > Insurance Templates.

Practices can create multiple templates based on their requirement.

Let's walk you through on how to manage the four tabs under the Insurance template:

Coverages
Alternative Benefits
Pre- Authorization Codes
Exclusions & Limitations

1. Add Coverages Template

Take a look at this tutorial for a brief walkthrough.

Select the Coverages tab:
Click +Add Coverage Template.

On the Add Coverage Template:

Select Copy from Existing or Create New.

If you have selected the Copy from Existing option:

Select a Template.
The Template Name will be prepopulated upon template selection.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

If you have selected the Create New option.

Enter the Template Name.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

Once the template is added, click Edit on the top right of the template.

In the Coverages section:

Select the template.
Click Edit on the top right.

Click +Add Code Category.

Enter code Category Name.
Add the Default Coverage in percentage.
Add the Waiting Period in
- Days
- Weeks
- Calendar Months
- Years
Select Maximums Waived as Yes or No.
Select Deductible Waived as Yes or No.
Select the codes and click the right arrow mark to move the codes from Available Codes to Selected Codes sections.
Click Save.

2. Add Alternative Benefits Templates

Watch this video for a concise summary.

Select the Alternative Benefits tab:
- Click +Add AMB Template.

On the Add Alternative Benefits Template modal:

Select Copy from Existing or Create New.

If you have selected Copy from Existing option:

Select a Template.
The Template Name will be prepopulated upon template selection.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

If you have selected Create New option:

Enter a Template Name.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

In the Alternative Benefits section:

Once the template is added, click Edit on the top right.

Click +Add AMB Code.

Select the alternative Treatment Code you want to apply against the first treatment code.

Select Alternate Benefits.
- Choose a preset from the Select Teeth Preset.
- Select the Teeth from the tooth selector.
- Click Apply

Click +Add Rule to apply a certain treatment code for a particular tooth or teeth.
Click Save.

Note: System Template for AMB codes is a default template. Users can change the default template as needed.

3. Add Pre-Authorization Codes Templates

Watch this video for a step-by-step explanation.

Select the Pre-Authorization Codes tab.
- Click +Add Pre-Auth Template.

On the Add Pre-Authorization Codes Template:

Select Copy from Existing or Create New.

If you have selected Copy from Existing option:

Select a Template.
The Template Name will be prepopulated upon template selection.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

If you have selected Create New option.

Enter a Template Name.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

Under the Pre- Authorization Codes tab:

Once the template is added, click Edit on the top right.

Select the codes and click the right arrow mark to move the codes from Available Codes to Selected Codes sections.
Click Save.

4. Add Exclusions & Limitations Template

Watch this video for a quick walkthrough.

Select the Exclusions & Limitations tab.
- Click +Add Exclusions & Limitations Template.

On the Add Exclusions & Limitations Template tab:

Select Copy from Existing or Create New.

If you have selected Copy from Existing options:

Select a Template.
The Template Name will be prepopulated upon template selection.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

If you have selected, Create New option.

Enter a Template Name.
Mark the checkbox as Set as Default if you need to mark this template as default.
Click Save.

In the Exclusions & Limitations section:

Once the template is added, click Edit on the top right.

Within the Diagnostics, you can make changes such as:

Add or remove Codes for Exclusions & Limitations.
Edit the Frequency based on the requirement.
Enter the Alert Content.
Click Save.

Note: Users can use the three-dot menu at the end of any template to Rename, Duplicate, Set as Default, or Delete the Template.

Employers

Employers refer to businesses that provide dental insurance benefits to their employees. When managing insurance plans within CareStack, you can associate employers with specific insurance plans. Let's see how to add, view, edit, or delete employers in CareStack.

Watch this video for a complete understanding.

Add an Employer

Navigate to the System Menu > select Practice Settings > Insurance Manager > Employers.

Click + Add New Employer.

Enter Employer Name. You can enter other optional information such as Address, Zip, City, State, Website, Contact Details, etc.
Click Add Employer.

View or Edit an Existing Employer

You can view the existing employers in Practice Settings (System Menu > Practice Settings > Insurance Manager > Employers).
The employers are listed on the grid with their Name, Contact Name, Email, and Website details.
Click View to see the 'Employer Details' and 'Contact Details'.
If you want to update the details you can directly click on the corresponding Edit button.
- You can also edit from the View screen.

Merge Employers

To merge two or more employers, perform the steps below.

From the Employers page, click Merge Employers.

Select the Employers and Employers to be Merged from the drop-down menu. You have the option to select multiple employers.
Click Merge.

To view the merged employers, mark the Show Merged Employers checkbox.

Download the Employers List

To download the employers list, click Download from the Employers page.

Carriers

Watch this video for a quick overview.

Add a Carrier

Navigate to the System Menu >select Practice Settings > Insurance Manager > Carriers.

Click + Add Carrier.
Enter the following mandatory details:
- Carrier: The intended carrier name.
- Name to be Printed in Forms: If any other name is required to be printed in the forms.
- Address Short Name: A quick name for the address.
- Address Lines, Zip, City, State: Exact address information.
Click Save.

Once the carrier is configured, users can set up all the other tabs, such as:

Address Details
Claims Addition Provider IDs
Alternative Benefits
Coverages
Pre-Authorization Codes
Exclusion & Limitations.

Select the Alternative Benefits tab; the default template for Alternative Benefits that was set in the template will be pre-populated.
You can also modify the existing AMB Codes by clicking on Edit.

Click +Add Rule to add another treatment code.
Additionally, users can add AMB codes by clicking +Add AMB Code.
Click Save.

Once you click Save, the user will be prompted:

Save for this Carrier: Applies changes only to this instance and removes template mapping.
Update template: Updates the existing template with any changes impacting all linked instances.
Save as new template: Creates a new template and maps this instance to it.

Tip: The edits you make for AMB Codes inside the carriers will also be reflected on the template associated with it. Similarly, you can edit other tabs such as Coverage, Pre- Authorization Codes, Exclusion & Limitations.

Merge Carriers

To merge two or more carriers, perform the steps below.

From the 'Carriers' page, click Merge Carrier.
Select the Carrier and Carriers to be Merged from the drop-down menu. You have the option to select multiple employers.

Note: Only 20 Carriers can be Merged at a time.

Click Merge.
To view the merged carriers, mark the Include Merged Carriers checkbox.

Download the Carriers List

To download the employers list, click Export from the Carriers page.

Plans

Watch this video for a concise summary.

Add A New Plan

Navigate to the System Menu > select Practice Settings > Insurance Manager > Plans.

Click +Add New Plan.

Enter the mandatory information like Carrier Name, Name, Plan Type, Insurance Type, etc.
Checkmark Mark Insurance as Verified or,
Click Save to save the details as a draft.

Once the Plan is configured, users can set up all the other tabs, such as:

Details
Benefits
Coverages
Missing Tooth Clause
Alternative Benefits
Pre-Authorization Codes
Exclusion & Limitations
Fee Schedule Assignment

Select the Alternative Benefits tab; the default template that was configured for AMB Codes in the carrier section will be automatically prepopulated.
You can also modify the existing AMB Codes by clicking on Edit.

Click +Add Rule to add another treatment code.
Additionally, users can add AMB codes by clicking +Add AMB Code.
Click Save.

Once you click Save, the user will be prompted:

Save for this Plan: Applies changes only to this instance, and removes template mapping.
Update template: Updates the existing template with any changes, impacting all linked instances.
Save as new template: Creates a new template and maps this instance to it.

Note: You can also edit other tabs such as Benefits, Coverages, Alternative Benefits, Pre-Authorization Codes, Exclusion & Limitations and Fee Schedule Assignment.

Other Actions in the 'Plans' Page

To merge plans, perform the steps below:

Click Merge Plans.

Select Destination Plan and Plan to be merged
Click Merge.

To view merged plans, checkmark the Show Merged Plans checkbox.

To activate or deactivate the plans, perform the steps below:

Select the required plan(s).
Click the three dot menu.
Click Activate or Deactivate as needed.
You can also directly Activate or Deactivate from the listing page.

Note: You can checkmark the Show Deactivated Plans checkbox to view deactivated plans.

Manage Settings