Insurance billing and claims follow-up
BOC’s insurance desk is where your clinic keeps insurance companies and their policies, splits each bill between the patient and the insurer, and follows every claim until it is collected. The patient pays their share at the cashier, and the insurer’s share waits on the desk under Outstanding to collect.
What it does
Turn on insurance and the Insurance page becomes your insurance desk. Three cards at the top show Collected from insurance, Outstanding to collect, and Insurance operations for the dates you filter, each with View more. Below them, every insurance company has its own card with its legal name, contact, phone, email, address, tax ID, and notes, the number of policies, and its totals: collected, outstanding, and operations. Each card opens its Collected and Not collected yet bills, View more, Edit, and Create policy, and Archive retires a company or a policy, with a confirmation when bills are still open.
On the patient’s Customer File, the Insurance tab links the person to a company and one of its policies, and shows the policy terms in one line, such as 20.00% / 80.00% · All services. The tab also keeps the policy number, coverage type, start and end dates, plan type, group number, the primary insured and the patient’s relationship to them (Self, Spouse, Child, Parent, or Other), the insurance status (Active, Expired, Suspended, or Unknown), photos of the card front and back, and notes. Usage history lists every insured bill with the bill total, patient share, insurer share, collected, and outstanding, each followed by its currency, plus the doctor, the approval, who entered it, and the payment details.
At the cashier, staff choose the payer: Personal / the customer, or Insurance. With Insurance, BOC finds the patient’s company and policy, shows the split, and takes the patient’s part as a normal payment. If the insurer pays part on the spot, the cashier enters it in Insurance amount collected now, and the rest of the insurer’s share becomes an insurance bill on the desk, ready to collect.
Policy rules, pre-approvals, and claims
Each policy has a name and code, a Patient share percent, Valid from and Valid until dates, a Maximum insurer amount, the covered services (All services or the ones you pick), and a Requires approval switch. BOC splits each bill with those rules: the patient pays their percentage, and the insurer pays the rest up to the maximum for that bill, with any amount above that cap added to the patient’s share. A service outside the policy is paid in full by the patient, and a card outside its valid dates asks the cashier to confirm before continuing.
When a policy requires approval, the visit needs a pre-approval first. On the Insurance tab, Add approval links a visit to an approval number, an approval date, an expiry date, and a status: Approval pending, Approval granted, Approval rejected, or Approval expired. The cashier can bill the insurer once a granted approval for that visit is on file; until then BOC shows Enter the approval number in the patient file.
Claims follow-up starts from Outstanding to collect. The Not collected yet list shows each insurer bill with the patient, date, service, doctor, the approval number or No approval needed, the company and policy, and the bill total, patient share, and insurer share, with the bill total, collected, and outstanding added up at the top. Filters narrow it by start and end date, service, and gender, and opening a company from its card shows that insurer’s bills only. It is the list your team works through with each insurer until every claim is paid.
Collections you can trace
When an insurer pays, tick its bills and press Mark selected as collected, or Mark all collected for the whole filtered list. BOC asks you to confirm the number of bills and their total, then records one collection per company and currency for the amount still open on those bills and moves them to the Collected list with the collected date. Each bill keeps its own currency, and the desk totals show in the clinic’s main currency. The company card updates its collected and outstanding totals, and View all numbers lists every bill with the patient, date, amount, and status for checking against the insurer’s statement.
BOC records every collection with the person who marked it, the amount, and each bill’s balance before and after. If a bill was marked by mistake, Undo or Mark not collected puts it back on the outstanding list with a reason, and the Activity Log shows who changed it, the amount, and the reason. On the desk, View Insurance, Edit Insurance, and Collect Insurance are separate permissions, and the patient’s Insurance tab has its own view, add, edit, and delete permissions. Policy terms are edited only on the insurance desk, so the front desk links a patient to a policy while managers keep the terms.
The BOC app carries the desk too. Staff see the three desk cards and each company’s collected and outstanding totals, open View all numbers, filter bills by From and To dates, mark bills collected or undo a collection with a reason, manage a patient’s insurance with card photos and pre-approvals, and choose Insurance as the payer at the cashier. Insurance companies and their policies are set up on the web desk.
How it works in BOC
- Add the company. On the Insurance page, press Add insurance company and fill its legal name, contact, phone, email, and tax ID.
- Create its policies. Press Create policy and set the patient share percent, valid dates, maximum insurer amount, covered services, and whether approval is required.
- Link the patient. On the Customer File, open Insurance, choose the company and policy, and add the card photos and policy number.
- Add pre-approvals. For policies that need one, use Add approval with the visit, approval number, dates, and status.
- Bill at the cashier. Choose Insurance as the payer. The patient pays their share, and the insurer’s share goes to Outstanding to collect.
- Mark claims collected. When the insurer pays, select the bills under Not collected yet and press Mark selected as collected.
Who it is for
Clinics Reception takes the patient’s share at the cashier while the insurer’s share waits on the desk for collection.
Dental clinics Pre-approvals for crowns, implants, or root canals are tracked per visit, with the approval number on the patient file.
Dermatology and laser Covered dermatology visits split automatically, and cosmetic services outside the policy are billed in full to the patient.
Physiotherapy Each session of a covered course becomes an insurer bill, so the practice sees what the insurer still owes for the whole course.
What your team gains
- Patient and insurer shares split on every insured bill.
- A maximum insurer amount per policy, with the rest on the patient.
- Pre-approvals per visit, with number, dates, and status.
- A clear list of insurer bills still to collect.
- Bulk Mark selected as collected, with a confirmation of count and total.
- Card photos, policy number, and usage history on the patient file.
- Usage history with the currency after every amount, on the web and in the BOC app.
Questions
Does BOC handle insurance billing for clinics?
Yes. You set up insurance companies and their policies, link each patient to a policy, and choose Insurance as the payer at the cashier. BOC splits the bill, takes the patient’s share, and keeps the insurer’s share as a bill to collect.
How does BOC split a bill between patient and insurer?
The policy sets the patient share percent, and the insurer pays the rest. If the policy has a maximum insurer amount, the insurer’s part of each bill stops at that cap and the patient pays the difference.
Can I track insurance pre-approvals?
Yes. On the patient’s Insurance tab, Add approval records the visit, approval number, approval date, expiry, and a status of pending, granted, rejected, or expired. For a policy that requires approval, the cashier bills the insurer once a granted approval is on file.
How do I follow up on unpaid insurance claims?
Open Outstanding to collect on the Insurance page. Every insurer bill still waiting for payment is listed with the patient, service, doctor, approval, policy, and shares, filtered by dates, service, and gender or opened per company, and you mark the paid ones collected in one step.
Can one insurer payment cover many bills?
Yes. Select every bill the payment covers and press Mark selected as collected. BOC confirms the count and the total, then records one collection for each company and currency.
What if a service is outside the patient’s policy?
BOC shows that the service is outside the policy, and the patient pays the full amount at the cashier. Policies can cover all services or a list you choose.
Can I follow insurance claims from the mobile app?
Yes. The BOC app shows the insurance desk totals and each company, lists the bills to collect, and lets staff mark them collected or undo a collection with a reason. It also manages each patient’s insurance and pre-approvals, while companies and policies are set up on the web.