What is insufficient coverage in SAP IS-H - SAP for Healthcare?

SAP Term: insufficient coverage

• Component: IS-H

• Component Name: SAP for Healthcare

• Description: SAP Healthcare - Industry-Specific Components for Hospitals Occurs in the following cases: When the system only proposes partial coverage for a service 80%, for example on the basis of pre-approved insurance or default values. When you manually lower the service costs covered below 100% or lower coverage to an amount less than the basic price.

Smart SAP Assistant

• Key Concepts: 
  Insufficient coverage is a term used in IS-H SAP for Healthcare to describe when a patient does not have enough insurance coverage to cover the cost of their medical services. This can occur when the patient has a high deductible or co-pay, or when the insurance company does not cover certain services. 
  
  How to use it: 
  When a patient has insufficient coverage, the healthcare provider must determine how to proceed. The provider may be able to negotiate with the insurance company for additional coverage, or they may need to find other ways to cover the cost of the services. In some cases, the provider may need to provide the services at a reduced rate or waive them altogether. 
  
  Tips & Tricks: 
  It is important for healthcare providers to be aware of their patients' insurance coverage and any potential issues with insufficient coverage. Providers should also be familiar with their own policies and procedures for dealing with patients who have insufficient coverage. 
  
  Related Information: 
  Insufficient coverage is just one of many issues that healthcare providers must deal with when providing medical services. Other issues include billing errors, coding errors, and incorrect diagnosis codes. It is important for providers to stay up-to-date on all of these issues in order to provide the best care possible for their patients.