how to setup credits client

Log in using an account with access to the Claims or Admin Department

1. From the left menu, go to Setup & Configuration then Setup Credit Clients

2. Click New at the top of the page

3. Enter the Agency Name (e.g., NHIS)

4. Select the Agency Type (Company or Insurance)

5. Set Auto Verification (default is Yes, change if needed)

6. Choose whether insurance should be verified each time a patient visits

7. Set Status (default is Active, change if needed)

Heads-up:

You cannot save the package without setting up a plan.

1. Click on Setup Plan.

2.  Enter the name of the policy.
   Example: “30-Day Credit” or any custom policy name.

Heads-up :

Changes can be made if needed, depending on the insurance or company policy. If no changes are required, enter the policy name, then scroll down and click Add

ii. Capacity

Select the appropriate capacity option for the policy.

Heads-up:

A default capacity setting is already provided. Only modify it if required by the insurance provider.

Capacity Options Explained

1. OPD: No Limit | Ward: No Limit
   The client can access both OPD and admission services without any limit.

2. OPD: No Limit | Ward: With Limit
   OPD services have no limit, but admission services have a defined limit.

3. OPD: With Limit | Ward: No Limit
   OPD services have a limit, but admission services have no limit.

4. OPD: With Limit | Ward: With Limit

Both OPD and admission services have limits

3. More Options

Choose how the system should handle OPD bills when a patient gets admitted:

1. Option 1: When the patient is admitted, move the OPD bill to the IPD

2. Option 2: When the patient is admitted, do not move the OPD bill to IPD
   
   

Select the option based on the policy requirement.

Both OPD & IPD

Enter the total allowable amount for both OPD and admission combined.

Cap – OPD

Enter the allowable amount for OPD visits only (if the policy requires a limit).

Cap – IPD

Enter the allowable amount for admission (IPD) only (if required by the policy).

5. Maximum Dependents

Enter the maximum number of dependants allowed under this plan.

6. Frequency

Select the applicable policy frequency (e.g., Monthly, Per visit, Yearly).

7. Services Covered

Head up 

By default, all covered services are checked.

1. Uncheck any service that is not covered by the policy.

1. Click the Add button to include the plan.

2. Click Save to complete and store the policy setup.

The new insurance package will now appear in the list and be available for use in claims processing.