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UK Insurance Step 2 - Billing Codes & Contract Rates 🇬🇧 (Duplicate to include Healthcode)

  1. UK Insurance Billing
  2. UK Insurance Step 2 - Billing Codes & Contract Rates 🇬🇧 (Duplicate to include Healthcode)

    3. 7 min read

We’ve broken this guidance up into small, digestible chunks. You’ll find links to the other steps at the bottom of the page.

Jane has a really clever way of allowing you to set a default or private price for a treatment, while allowing you to override that price based on the fee structure of any third parties you work with. Jane uses billing codes and contracted rates to help you manage this. If you’re new to Jane, your previous software might have labelled them “fee codes” or “charges”.

Creating your billing codes

To get started, head to Settings > Billing Codes

In this area, you can click New Billing Code

Set the Type as Billing Code, and then complete the remaining fields. Let’s create an example code for a Chiropractic Initial Assessment:

  1. Set the type as Billing Code.
  2. Give the code a name (you can search for codes by name in your diary and inside insurance policies). If the insurers you work with require you to include a specific name for the treatments or services you offer, input that here.
  3. Give the code a label, such as the discipline.
  4. This is the clever part 🤓. Set the default rate for the code. This could be either your private rate, or the rate you’ll most commonly charge (e.g. the rate for the insurer you do most work with).

After setting the default rate, you can populate your agreed contract rate with each insurer/third party. Jane uses these contract rates to override the default price of an appointment, depending on the insurer/third party linked to the patient.

For example, if I created an AXA insurance policy on a patient’s profile, then add the ‘Initial Assessment - Chiropractic’ code I created to their appointment, Jane will automatically change the fee for the visit to £55 based on my settings. 

Make sure to hit Create Billing Code to save your work.

We’ll take a look at how the billing codes and contract rates come into play when setting up insurance policies and managing your invoices in a subsequent guide. For now, let’s move on to creating insurance policies for your patients!

Billing Codes and Healthcode

Once you have configured Healthcode and set your Healthcode Insurer Identifier for each insurer (link to Step 1 guide), you’re all ready to start creating some custom Billing Codes and favouriting your frequently used Diagnosis Codes. Both are super important for the validation process when submitting XML files to Healthcode, so we’ve made it as simple as possible for you to access your most frequently used codes when required.

First, you’ll want to navigate to Settings > Billing Codes, and you’ll see the following Code Sets enabled for you:

ICD9-UK

Healthcode-ISC

If not, just pop a tick in the box alongside the relevant set, and you can click to Save Billing Code Sets

In the same way as above, let’s walk through how you can set up different rates for each insurer depending on the treatment offered when you’re using Healthcode.

  1. Filter to show just the Healthcode ISC Billing Codes
  2. Search for the codes that you currently use
  3. Click Assign Rate
  4. Set your Default Rate and populate the contracted rate for each insurer/third party.
  5. Click Create Billing Code to save your work

Here’s an example of how this works. Let’s say that in my clinic I offer an Initial Physiotherapy Assessment and the private price of that treatment is £75. I can search for the relevant code here:

Then, I can click to Assign Rate

If both AXA and BUPA will pay £50 per patient for this treatment, then after entering the default rate of £75 I can enter the contracted rates for each insurer:

Then if I created an AXA insurance policy on a patient’s profile, and added the ‘Initial Assessment - Physio’ code I created to their appointment, Jane will automatically change the fee for the visit to £50 based on my settings. Clever, eh? Let’s not get ahead of ourselves. More about that later!

So, once you’ve followed the steps above for all the Billing Codes you use, then you’ll see your Custom Billing Codes populate at the top. As I say, we’ll walk you through how this makes things a whole lot easier when adding billing codes to an appointment in the next guide:

Diagnosis Codes and Healthcode

Just like with Billing Codes, we make it super easy for you to find and favourite your most frequently used Diagnosis Codes. Any codes that you add will also be pulled through into the XML file that is generated for submission to Healthcode. Ready? Let’s get started.

Under Settings > Billing Codes you can search all Diagnosis Codes by set, and you can click the little star icon alongside the code to add it to your Favourites.

Here’s an example. Let’s say Shoulder Dystocia is one of my frequently used Diagnosis Codes. Here’s how I can favourite it.

  1. Search Diagnosis Codes for “dystocia”
  2. Find and favourite the relevant code

Once that’s done, you can click on the little star beside the search fields to view your compiled list of Favourites

Note: It’s worth bearing in mind that not all codes are valid for all insurers, and you may have to provide an alternative code in the event that it’s not accepted by Healthcode. You can read a little more about that here.

You can navigate to any section of this guidance using the links below:

Written by Jamie - UK Support Team
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