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Insurance

The Insurance tab is where you define the medical insurance providers (Obras Sociales) the clinic works with and the specific conditions for each plan. Keeping this database updated is vital for accurate billing and clear patient communication.

Insurance Provider Management​

From the main view, you can organize insurance companies:

Adding a provider​

Click "Add Insurance" (Agregar obra social) to create a new insurance provider entry (e.g., OSDE, Swiss Medical, AETNA, Blue Cross).

Active status​

Use the toggle to enable or disable an entire insurance provider. When toggled off:

  • The provider is immediately removed from the patient's booking options
  • Existing appointments with this provider are not affected
  • You can re-enable it at any time

Use case: If the clinic stops working with a particular insurance company, toggle it off rather than deleting it to preserve historical data.

Edit and delete​

  • Edit: Update the provider's name or details
  • Delete: Permanently remove the provider (only use this if it was created in error)

Plans and Statuses​

Within each insurance provider, you manage specific plans (e.g., Gold Plan, Family Advantage, Plan 210, Plan 310).

Accepted status toggle​

Each plan has an Accepted toggle:

  • On: The plan can be selected during bookings (both online and internal)
  • Off: The plan cannot be selected for online bookings
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Turning off a plan's accepted status is useful when the clinic temporarily suspends a specific plan but continues to work with the insurance provider's other plans.

Key Feature: Copago Plus​

Copago Plus is the configuration that triggers financial alerts throughout the booking system.

What it does​

When enabled on a specific plan, it indicates that the plan requires the patient to pay an additional out-of-pocket fee (copago) at the time of the consultation.

System effect​

When administrative staff selects a plan with Copago Plus enabled during appointment booking:

  1. An orange warning box automatically appears in the booking modal.
  2. The warning displays the custom Copago Plus message configured in the Configuration tab.
  3. Staff must verbally inform the patient about the additional cost before confirming.

Why it matters​

This feature ensures that:

  • Staff never forgets to inform patients about additional costs
  • Patients are not surprised by unexpected charges at the front desk
  • The clinic maintains transparency and trust with its patient base
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Failing to inform patients about Copago Plus fees is a common source of front-desk disputes. Always ensure staff follows the verbal notification protocol when the orange alert appears.

Best Practices​

  1. Keep the insurance database current. Outdated plans or providers create booking friction and billing errors.
  2. Use the active toggle instead of deleting providers when relationships change. This preserves historical data.
  3. Enable Copago Plus on every plan that requires an additional patient payment, no matter how small. Consistency prevents oversights.
  4. Run sample bookings across major plans after making changes to confirm both internal and patient-facing booking flows enforce the correct insurance constraints.
  5. Review insurance settings quarterly in coordination with the billing team to ensure alignment with current contracts.