On Insurance Policy Manager window for Apollo, you can now set policy limits for every class of products, allowing you to generate several cases where one single policy and its limits can be applied differently depending on product class.
This enhancement will allow you to set different scenarios where policies can be applied accordingly and will facilitate the approval of services and products. You will be able to add approval limits according to:
Patient type (ambulatory, hospitalization, emergency)
Product classes on your hospital (Drugs, Radiology, Procedures, Laboratory, etc.)
Here is the process of how you can set and apply these limits:
Go to the policy results from an insurance company in Insurance Policy Manager window, click context menu (three dots) and then click Insurance Information:
Now set filters by selecting Patient Type, Product Class and Service Station (if you have different policy requirements for two or more equal service stations that perform the same services or medications).
Enter the amounts for Maximum limit, Approval Threshold, Follow up limit, Coinsurance, etc.
Save.
Our latest update will display the whole list of approval cases that you have already set for each policy by showing Patient Type, Product Class and Limits columns:
You can set amounts according to these filters, allowing you to collect services, medications and other charges according to their product category policy limits.
We hope this improves your Cirrus experience. Remember to share this information and ask for help if you need it.
Date: April 25, 2022