Clinical add-on
Included in every plan
Insurance Classes
Insurance classes, coverage rules and claim-ready invoices for clinics.
Read the manualWhat it does
Insurance classes, coverage rules, and claim-ready invoices for clinics that split a single visit between patient and insurer. Every service can have per-class coverage percentages, co-pays, and visit caps.
Key capabilities
Every moving part.
- Tiered insurance classes
- Define unlimited insurance classes — BUPA Gold, Tawuniya Silver, Allianz Plus — each with its own coverage profile. Classes are reusable across patients and can be edited centrally without touching individual records.
- Per-service coverage rules
- Set coverage percentage per service per class, with optional per-visit caps and annual ceilings. Cosmetic services can be excluded outright; specialist procedures can require pre-approval.
- Auto co-pay at POS
- Co-pay is calculated at checkout based on the patient's class, the service rules and any deductible already met this period. Reception sees the patient share, the insurer share and the visit total without lifting a calculator.
- Claim-ready invoice exports
- Each invoice exports a claim package with the insurer-share line, patient-share line, service codes and supporting documents. The format is ready for the insurer portal — or the printable claim form, if that is what your provider still wants.
- Patient policy on profile
- Each client carries their insurance class, policy number and validity period on their profile. Expired policies surface as a warning at checkout so reception verifies before serving — never after.
- Claims dashboard
- A dedicated dashboard shows claims volume by class, by provider and by status — submitted, paid, partially paid, rejected. Aging tells you which insurers are dragging payment so you can apply pressure where it matters.
Who it's for
"Dental, medical and aesthetics clinics with mixed-insurance patients."
Setup
Four steps from enable to production — no external services required.
From disabled to live.
01
Create insurance classes under Catalogue → Insurance
02
Define coverage rules per service (percentage + cap)
03
Assign each patient's insurance class in their profile
04
Book a visit — co-pay is calculated automatically at POS
Integrates with
The modules this add-on plugs into out of the box.
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