Page 65 - R2P Front Desk Manual v1

Insurance Benefits Key Terms & Inputting in WebPT

When verifying a patient’s insurance benefits and inputting or updating them in WebPT, it is
important to be as detailed as possible. All information should be recorded in the following
sections of a patient’s chart:
1. Chart Note - record all information when verifying benefits
2. Insurance - record after benefits have been verified
3. Case - record in Additional Info section after benefits have been verified so that
information is easily visible in the patient’s chart (copay/deductible amount, visit limit & if
any used, auth/referral requirements, etc.)

To input a patient’s Policy Information into their Insurance in WebPT, understand the following
terms (graphic of Edit Insurance section on following page):

Visits Allowed: The maximum number of visits a patient’s plan will cover during their policy
year.

Visit Reset Date: Used to reset a patient’s visit number after their policy year has ended.
● To reset, select Yes and input the first day of the new policy year.

Policy Dates: Manually enter the dates from which a policy begins to when the policy ends.
● Policies run on either a calendar year (1/1 - 12/31) or a plan year (i.e. “renews every
July”), unless it is terminated prior to the year’s end.

Copay/Coinsurance: Copay is a set amount the patient pays at every appointment.
Coinsurance is the percentage of billable charges per appointment that will be the patient’s
responsibility after their deductible has been met (i.e. 80/20% coinsurance: insurance company
will pay 80%, the patient will be billed for the remaining 20%).
● Though much less common, it is possible for a copay amount to apply after a deductible
has been met (instead of a coinsurance). It is also possible for a patient to have a
coinsurance responsibility without having a deductible to first meet.

Deductible: The amount the patient pays for covered health care services before their
insurance plan begins to pay.
● If a patient has not met their deductible, then the clinic collects $50 per appointment (or
$70/appointment if UHC because we have a flat rate fee) to be put towards their
deductible. They will be billed for any remaining amount that the $50 payments do not
cover after charges have been processed.

Last Update: 7/10/19