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Insurance Flow for EHRs

In the Bookadoc, there are several mechanisms for handling patient insurance. One of the primary methods is through EHR appointment syncing.

Insurance Intake via EHR Appointment Sync​

When a patient books an appointment outside of Bookadoc — through Tebra or another EHR — the following process is triggered:

  1. Account Creation
    A new Bookadoc account is created for the patient automatically(Stealth Account).

  2. Insurance Extraction
    The patient’s insurance information is extracted from the external EHR (e.g., Tebra).

  3. Eligibility & Coverage Checks

    • We validate the extracted insurance.
    • A coverage check is performed to confirm the insurance is active and in or out of network.

  4. Database Storage

    • Validated insurance details are saved to our database.
    • This allows for reusability and reference during future appointments.

Handling Returning Patients​

When the same patient books a subsequent appointment:

  • The system checks whether their insurance already exists in our records.
  • If it does exist:
    • The insurance record is updated if needed.
    • A new eligibility check is performed.
  • If it does not exist:
    • A new insurance entry is created.
    • Eligibility checks are conducted as part of the new record creation.

Insurance Pull During Pre-Fill Workflow​

In workflows where patient information is pulled for pre-filling basic information (e.g., for forms or check-in), the system also retrieves and attaches the patient's insurance data.

This approach ensures that insurance data is always up to date, accurate, and verified during critical patient interactions.