Coverage policies in SigmaMD are designed to provide patients with discounts or special pricing on certain charge items. These policies can be applied across different membership plans, allowing you to manage and organize discounts and pricing rules efficiently. By making these settings centralized, you can customize their offerings to meet the diverse needs of your members.
Creating a Coverage Policy
To create a new coverage policy, navigate to the "Coverage Policies" section under the "Memberships" menu. Click on "Create Policy" to open the form for creating a new coverage policy. Here's a detailed breakdown of the form:
Policy Name: An open text field to enter the name of the policy. Allows special characters and has a maximum limit of 100 characters.
Add Membership Plans: Search and select membership plans to which this policy will apply.
Managing Coverage Policy Rules
Once you have entered the basic details and selected the relevant membership plans, categories, and items, you can define specific rules for the policy:
- Select Category: Choose the category of charge items the rule will apply to.
- Search for an Item: Narrow down to specific items within the selected category.
- Free of Charge: Define if the items should be free under certain conditions (monthly limits, thresholds, or always).
- Adjust Price: Set discounts, surcharges, or replace the standard price with a specific amount.
Click "Save Rule" to add the rule to the policy. You can add multiple rules to a single policy, each applying to different items or categories.
These policies can be tailored to meet various needs through flexible rules, ensuring that your practice can offer personalized and financially sustainable benefits to members, enhancing their satisfaction and engagement.
For instance, you can create a policy where "Vitamin D Supplement" is free for up to 5 packs per month, and any additional packs within the same month receive a 10% discount. Another example could be setting a rule where "Annual Wellness Visit" services are always free of charge, regardless of the frequency.
Finalizing the Coverage Policy
After setting up the rules, click "Create Policy" to save the coverage policy. The created policy will now be applied to the selected membership plans, ensuring that patients enrolled in those plans receive the specified discounts or special pricing on the designated charge items.
Rules will be applied to any new invoice or on current invoices if a change is made to their charges.
Coverage policies in SigmaMD offer a robust way to manage discounts and special pricing for patients. By creating centralized policies that can be used across multiple membership plans, you can efficiently organize and customize their offerings. This flexibility helps in providing tailored benefits to different patient groups, enhancing their overall experience.
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