Incomplete Constants: Insurances

The following functionality is exclusive to Self-Service Members. If you are a RevEquip Member and need to make changes to an Insurance, submit the changes to updates@webpt.com.

Admins have the ability to set up and edit Insurances for proper claim submission and payment posting. 

  1. From the Admin menu, select Incomplete Constants.
  2. Select the Search Criteria, then click Search.

    For users with access to multiple companies : If you do not narrow down the search results to the company you're currently logged into, opening an incomplete constant in another company will automatically log you into that company. Be sure to change back to your preferred company once you've completed your updates.

  3. From the search records shown, click the Count number for the Insurances line.
  4. From the records shown, click the Insurance Code for the record you wish to work. 
  5. On the Insurances screen, enter the following missing information to complete the mapping. For a complete breakdown of each available field, click here.

    Balance Type : This field determines if a patient statement is sent. Workers Comp is the only option that will not send a statement. 

    1. Insurance Class: Group the payer in their appropriate financial class. Use the magnifying glass to pull up a search box. This is important as each financial class has specific claim formatting rules automatically applied to ensure proper billing. You can find a list of Insurance Classes here.
      1. For Private Insurance, use PW if you cannot find the specific commercial payer.
      2. For Medicare Advantage plans, you must select Medicare Advantage as the Insurance Class. 
      3. For Medicare Supplemental plans, DO NOT select Medicare Advantage as the Insurance Class.
    2. Insurance Type ID: This field adds additional formatting rules to your claims. Selections include Medicare, PTPN, Self Pay, and Other. 
    3. Payer Description: Enter the Payer ID, Payer name, or Outbound Payer ID in the Payer Description field. Select the correct insurance from the drop-down. Use the magnifying glass if your initial search does not return any results.

      Note: When completing your EDI enrollments in Change Healthcare, you’ll be able to locate the Payer ID. This does not include Medicare. If you have trouble locating the correct payer description, we recommend logging into Change Healthcare and viewing those enrollments. 
      1. If claims should be submitted on paper and do not require attachments, search for CMS15
      2. If claims should be submitted on paper and do require attachments, search for Attach.
    4. Authorization Required: Use the Authorization Required checkbox to automatically hold any claims that are missing authorization. These claims are placed on the Delayed Claims report and can be released from the Release Claim Delay page when the authorization has been added.
  6. In this example, three of the four required fields were Incomplete Constants. Enter the missing information and click Save. This will complete the constant and automatically remove it from the worklist. 

What causes an Insurance to appear on the Incomplete Constants report?

An insurance will appear on the incomplete constants report if any of the following fields are left blank:

  • Insurance Name 
  • Address 1
  • City 
  • State 
  • Zip Code 
  • Insurance Class 
  • Payer 
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