Setting up insurance

Insurance setup is managed in Settings → Insurance. In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance. Owners and admins use this page for organization-wide insurance settings. Clinicians who open Insurance see a personal page for their own billing NPI instead.

Use Insurance features (1) to turn on insurance setup for the organization. After that, the page shows Patient intake, billing provider details, Payer Whitelist, Benefits to show, and team rendering NPI sections below.

How do I turn on insurance features?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance to make the insurance setup sections available for your organization. The change is a draft until you click Save.

Use Insurance features (1) to turn this setting on.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance.
2. Turn on the switch at the top of the page.
3. Click Save.

After the change saves, Ona shows Benefits to show, Patient intake, billing provider details, Payer Whitelist, and team rendering NPI settings. The payer whitelist section saves on its own.

How do I require insurance during intake?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance when patients must add at least one plan before they can finish intake.

Use Require insurance (1) to make insurance required during intake.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance.
2. Make sure insurance features are turned on.
3. In Patient intake, turn on Require insurance.
4. If you also want patients to add card photos, turn on Require insurance card photos.
5. Click Save.

Patients must add at least one plan before they can finish intake. If Require insurance card photos is also on, they must add photos of the front and back of the card before they can finish.

How do I enter billing provider details?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance to store the organization information used on claims. Edits are drafts until you click Save.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance.
2. Make sure insurance features are turned on.
3. Enter the billing provider identity: billing NPI, billing taxonomy code, billing provider name, and EIN.
4. Enter the billing provider phone and billing address.
5. Add Enrollment contact email if you want an enrollment contact stored with the billing provider details.
6. Click Save.

Use Billing NPI (1) for the organization billing number, Tax ID (2) for the tax identifier, Legal name (3) for the billing entity name, and Enrollment contact email (4) if you want an enrollment contact on file.

Ona validates key billing fields before saving them, including NPI, taxonomy code, billing provider name, EIN, US phone number, state, and ZIP. Billing provider name is limited to 60 characters, shows an inline error when it is too long, and keeps Save disabled until you fix it.

How do I add rendering NPIs for team members?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance to enter the individual NPI for each team member who bills insurance. The organization billing NPI identifies the billing entity; the rendering NPI identifies the individual provider on claim service lines.

Use Team member (1) to find the person, then enter Rendering NPI (2) for that provider.

1. In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance.
2. Make sure insurance features are turned on.
3. In Team rendering NPIs, find the team member.
4. Enter their Rendering NPI.
5. Click Save.

After the save finishes, the member's rendering NPI is stored for insurance claims that use that provider.

What can't I do here?

In the left sidebar, click Settings (at the bottom). In the settings menu, under Insurance, click Insurance. Access and setup are limited in these ways:

• Staff cannot manage organization insurance settings from Settings.
• Clinicians do not manage organization-wide insurance setup here; they see their individual billing NPI page.
• Benefits to show is part of the organization insurance settings and saves with the main insurance settings.
• The payer whitelist saves on its own.
• Fee Schedule settings redirect back to Settings → Insurance when insurance features are not enabled.
• If Require insurance is on, patients without an insurance plan cannot finish intake themselves.
• If Require insurance card photos is on, patients also cannot finish intake until both card photos are added.

Common questions

Do I need to click Save?

Yes. On the Insurance settings page, click Save to save changes to the organization insurance switch, Benefits to show, Require insurance, Require insurance card photos, billing provider details, and team rendering NPIs. The payer whitelist saves automatically.

Why didn't the insurance switch save?

On the Insurance settings page, if you see Couldn't save, make sure a clearinghouse is selected, then try again. See Setting up your clearinghouse.

What is the difference between billing NPI and rendering NPI?

The billing NPI belongs to the organization billing entity. A rendering NPI belongs to the individual provider whose services are billed on a claim.

How long can the billing provider name be?

The billing provider name can be up to 60 characters. If you go over that limit, Ona shows an inline error and keeps Save disabled until you shorten it.

Should I turn on Require insurance if we see self-pay patients?

Use caution. When Require insurance is on, a patient must add at least one plan before finishing intake. If Require insurance card photos is also on, the patient must add both card photos too. A self-pay patient has to contact the clinic instead.

Where do I add a patient's insurance plan?

Patient insurance is managed from the patient record, not this settings page. See Patient insurance and card scanning.