Submitting to AG Insurance

Updated by Niki Budd

Submitting to AG Insurance

This integration allows system users to flag athlete incident reports for automatic submission to AG Insurance as part of a First Notice of Loss EDI transmission.
A certain minimum amount of data is required for each record sent. If this data is not present, then a notification will be generated for the account owner indicating such. Each night the job will attempt to re-send these incomplete entries, if the data has been updated.
Required data fields include: Athlete first name, Athlete last name, Athlete Date of Birth, Date of Injury, Primary Insurance Company, Primary Insurance Member ID, Injury Body Part and Affected Area
Most of these fields are required by our system when creating injuries or athletes, and should always be present. However; Primary insurance information (Company and Member ID) are optional, and may be added via athlete import or by editing the athlete details screens.
Please note that within the custom form builder you can AutoMap required data to prepopulate for AG Insurance Intake
The nightly push of data will NOT send the AG insurance document, you will need to send that independently
If you have an athlete in question as to whether or not the data has sent to AG Insurance properly, visit the reports tab for the "Suspended Insurance Data Submission Report."
The AG insurance integration requires the input of primary insurance information, if your patient does not have primary insurance it is requested that you submit the patient information manually to AG insurance. If you do not have the form, we can assign it to your account.

Step-By-Step Tutorial
  1. When creating a new Incident Report you will see the option to "Send to AG Insurance", select "yes"
  1. Once you have completed your SOAP note select "Save Incident Report"
  2. An overnight process will run and look for all injuries that have been marked for "Send to AG Insurance". A file containing this information will be generated and sent via ftps to AG insurance.
    If an injury has already been sent, then it will not be sent multiple times.
    There is no way to “un-send” an injury.
  3. If data is missing, the account owner will get a notification detailing the reason for error. Updating the missing information will allow the record to be sent again overnight.

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