Rethink/Kareo Initial Set Up Guide

Adding Service Locations in Kareo

Login to your Kareo Account
Go to “Settings”
1. Service Locations
  1. All service locations listed in Rethink must have a corresponding service location in Kareo
  2. To add a service location not in this list, click “New” at the bottom of the screen
  3. Internal Name: this should match the location name listed in Rethink EXACTLY
    1. NPI
    2. Time Zone
    3. Billing Name & Address
      1. Billing Name: company name that should go in box 32 when location is used
      2. Address: specific address for this service location for box 32
    4. Place of Service (POS): POS is driven from the appointment; however, if the funder requires for the facility location to always be listed in box 32 then you will want to replicate your service location to reflect all POS that could be attached to your claim (02, 03, 11, 12, etc.) by following the above steps.

Notes: this is directly related to column F on your billing export, whatever location is listed here is what is going to be looked up in Kareo (against internal name field). If the location does not exist, that line will fail as the location won’t be matched.

Adding Rendering Providers in Kareo

Login to your Kareo Account
Go to “Settings”
1. Providers
  1. Any providers in this list can be billed under when exporting the billing export from Rethink
  2. If your provider is NOT listed here, the billing export will fail
2. To add a provider not in this list, click “New” at the bottom of the screen
  1. On the general tab, add the basic information for the provider:
    1. Full name
    2. NPI number
    3. Specialty: this is the providers taxonomy code, click to search the taxonomy code list to find the best taxonomy for the provider
    4. Phone Number: all providers MUST have a phone number associated with them, common practice to add the practice phone number under Work
    5. User: all providers must have an associated user, this does NOT give them access to Kareo nor any permissions. Click “New” and add the providers email address – this will auto create a user for them
  2. Claim Settings
    1. This is where you can set up specific settings by funder for your provider
      1. Default settings are to bill under the group & individual NPI on claims (typical practice for most insurance companies)
    2. If you need to set this up differently for any funder, you will set that up under this tab
      1. Bill under individual NPI only
      2. Override group NPI
      3. Override TIN
      4. Override Claim settings
        This is where you can set up by funder, to do so, click “Add”
        Select the insurance company to assign the override settings for
        Click “Advanced Settings for more override options
    3. Save
      1. When prompted to check for discount, always select “no” as this does not apply for Rethink users

Notes: Depending on how your authorization is set up in Rethink will pull who is the rendering provider on your billing export. Whoever is in the column on the billing export is who the claim will be billed under. If they are not set up as a provider in Kareo, the export will fail.

Adding Insurance Companies in Kareo

Login to your Kareo Account
Go to “Settings”
1. Insurance
2. Insurance Companies
3. Click
  1. Most Commonly Requested: pulls payors based on your practice location of most commonly requested insurance companies, find funder and click the + next to the insurance company name
    1. Once all are added to your list, click save
  2. Search Other: if funder is not available on most commonly requested, search here – it will default to pulling only options in your current practice state but you can adjust the state in the drop down menu – select “ALL”
4. Once added to your list of insurance companies, you’ll have the option to complete the enrollment process (if applicable). You will see the status of each insurance company in your insurance companies list
  1. There are 3 columns that will reflect a corresponding status for each insurance
  2. Status options:
    1. Ready: insurance company does not require any additional enrollment
    2. Enrollment Required: must complete the enrollment wizard (steps iii below)
    3. Enrollment Requested: enrollment was submitted and pending further action
    4. Pending Insurance: insurance company has received the request, pending finalization
    5. Pending Practice: insurance company has requested information directly from practice to finalize request
    6. Pending First ERA: your enrollment has been approved by insurance to receive ERA files. Typically take 30-45 days for you to see your first ERA within Kareo. If it has been longer than 45 days, you can reach out to enrollments@kareo.com for a status update. When formulating the email, you will want to provide the following information:
      1. Practice name
      2. Practice ID: 66810
      3. Payer Name
      4. Payer ID
      5. Kareo Case # (this can be found by clicking on the down arrow next to the ERA column)
        
        Click on ERA to view Kare Case #
    7. Denied: insurance company has denied the request for enrollment
    8. Expired: action required from practice was not taken in a timely manner to continue enrollment process. Will need to re-enroll to start the enrollment process again by completing the enrollment wizard (steps iii below)
  3. Enroll in EDI (either claims or ERA)
    1. Note: most insurance companies will only require enrollment for ERAs (electronic remittance advice) this allows you to receive electronic EOBs to auto post payments for any claims billed out of Kareo – HIGHLY RECOMMENDED
    2. Go through the enrollments wizard by clicking on ‘enroll’
      1. Walk through the Enrollments wizard
        If you already have a signature form signed and uploaded to Kareo, you do not need to re-sign and upload, to verify, check your Documents in Kareo.
        Click “Documents” – “Find Documents”
        Any uploaded forms will be housed here

Notes: Important to remember that anytime you add a new insurance company with your practice you must first add them into Kareo – you will then also add them to your Rethink but you’ll want to set them up in Kareo first to avoid having to go back and map them together. If you set them up here first, you’ll have all the information you need to complete the mapping.

Adding Insurance Plans in Kareo

Once your insurance company is set up, you’ll need to also create an insurance plan associated to that insurance company
Go to “Settings”
1. Insurance
2. Find Insurance Plan
  1. This screen will show you all insurance companies you have linked to insurance plans and is a great outline of how you’ll map over to Rethink
3. To add new click “New” at the bottom of the screen
  1. Click to bring up a list of all insurance companies added under your practice to associate this new plan to
  2. Select insurance company
  3. Add Plan Name
    1. General note: we typically set up the plan name as the same as the insurance company name for ease although you can name it whatever you would like (especially if the insurance company name is long)
  4. Add Address
    1. Copy address for the particular insurance company/plan and click
      to format it to Kareo requirements
    2. Click “Save”
      1. You may get a warning that this is a duplicate plan being entered, click “OK”

Notes: Every insurance company must have a corresponding plan. The name of the plan must be exactly what you add in Rethink for mapping purposes. The “Find Plan” screen will show you exactly how your Funders in Rethink should be set up so always reference this screen in Kareo. If you do not have your insurance companies and plans mapped over correctly this will cause your billing export to fail or potential claim issues if plans are not added properly (missing addresses, plans not added to client’s chart, etc.).

Adding/Mapping Insurance Companies/Plans in Rethink

Once insurance companies and plans are added into Kareo, you’ll need to make sure you have corresponding funders set up in Rethink to map in your billing export
Prior to adding a new funder in Rethink, make sure you have your new insurance company listed
1. a.       Login to Rethink
  b.       Click “Company Account”
  c.       Click “Billing Kareo Payors”
  1. This list will be pre-populated with default Kareo payors, scroll through the list to check if your insurance company you just added in Kareo is listed. If it is, no further action needed
  2. IMPORTANT: the Billing Kareo Payor must match the insurance company name exactly as outlined/added in Kareo
  3. If the payor is not in the designated list or the name does not match exactly, click
    in the upper right corner to add a new payor
  4. Type in name exactly as outlined in Kareo (for Insurance Company, NOT plan)
Add a new Funder in Rethink
1. While in Rethink, click “Company Account”
2. Click “Funders”
  1. Click “Add Funder”
    1. Select Funder Type as Insurance
    2. Vendor ID is the electronic payor ID
    3. Name: you can name this whatever you would like and is used for internal identification only
    4. Kareo Payor: This is the Kareo Insurance Company
      1. Note: if you added a new one to the Billing Kareo Payors, this will always be at the bottom of the list
    5. Add all application contact information for the payor
    6. Select combine rules
    7. Add scheduling rules
    8. Add Insurance Plan(s)
      1. This should be exactly the same as the insurance plan created in Kareo
      2. Type and click enter to add plan option
    9. Select coverage type
    10.   Select service location
    11.   Add any applicable Notes
    12.   Click “Save”
Associate clients with new plans
1. Note: all clients must be associated with an insurance plan when adding an individual funder in their chart
2. Plan options will pull from the plan names added under the funder in the company account
3. Go to each individual chart and click on the client’s funder
  1. View/Add funder for client – when editing or adding, plan name will be an option, once a funder is selected/assigned, plan names will become available as a drop down. Select most appropriate plan based on client.

Notes: Once Funders and clients are mapped over to match Kareo payors/plans, this will allow your billing export to successfully sync and will avoid any potential failures. Helpful guide for remembering how to set up is referencing the “Find Insurance Plan” screen which outlines the set up exactly