Insurance Partners
Insurance partners are the insurers whose cards your business accepts. When a customer presents a valid insurance card, the sale is automatically split between the insurer and the patient according to the configured coverage percentage.
Access
- In the left sidebar, click Finance Zone.
- Click Insurance.
You will see a list of all configured insurance partners. If none exist yet, the list will be empty.
Add an insurer
Click Add Insurer (top right corner) and fill in the form:
Business details:
| Field | Description |
|---|---|
| Branch / Location | Your business location, if you operate in multiple branches |
| Insurance Short Name | Abbreviation used internally (e.g. SSN, CNAV, RSSB, RAMQ, CNAS) |
| Partner Full Name | Insurer's full legal name |
| Tax Identification / TIN | Insurer's tax number |
| CUI / CAEN | Business registration identifiers where applicable |
| Business ID | Insurer's business registration number, may match the tax ID |
| Address | Insurer's registered address |
Coverage:
| Field | Description |
|---|---|
| Default Coverage % | The percentage the insurer covers on qualifying products |
Click Save to create the insurer.
How coverage works
The Default Coverage % defines the payment split on every sale to a patient holding a valid card from this insurer.
Example: For an insurer which covers 75%:
| Party | Pays |
|---|---|
| Insurer | 75% of the qualifying amount |
| Patient | 25% of the qualifying amount |
Coverage only applies to products defined as qualifying under this insurer's formulary. Products not included in the formulary are billed entirely to the patient.
→ See Insurance Formularies to configure which products are covered.
→ See Insurance Co-Pay Dedicated to Pharmacies based in Rwanda subjected to RRA compliance.
Key points
| Point | Detail |
|---|---|
| Coverage % | Determines the insurer/patient payment split |
| Formularies | Define which products qualify for coverage |
| Multiple branches | Assign the correct branch when operating across locations |
| Short name | Used as the insurer label throughout the system |