{"id":15178,"date":"2024-05-07T11:54:13","date_gmt":"2024-05-07T11:54:13","guid":{"rendered":"https:\/\/docs.daftra.com\/?post_type=user_manual&p=15178"},"modified":"2025-10-05T11:18:12","modified_gmt":"2025-10-05T11:18:12","slug":"assign-an-insurance-agent-to-a-client","status":"publish","type":"user_manual","link":"https:\/\/docs.daftra.com\/en\/user_manual\/assign-an-insurance-agent-to-a-client\/","title":{"rendered":"Assign an Insurance Agent to a Client"},"content":{"rendered":"

[vc_row][vc_column][vc_column_text]After adding a new insurance company and insurance category in the previous tutorial, we will now link them with the clients so that the system can automatically apply insurance when creating invoices for this client. To do this, we need to have clients in the account.[\/vc_column_text][vc_column_text]Since we already have clients in our eyewear shop account, we will select one of our clients,<\/p>\n

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First, we click on \u2018Clients<\/strong>\u2019 in the main menu, then \u2018Manage Clients<\/strong>,\u2019 and select \u2018Client 1<\/strong>\u2019 as shown in the image.<\/p>\n<\/div>\n

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From the client profile, click on \u201cedit<\/strong>\u201c,<\/p>\n

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Below the \u201cAccount Details<\/strong>\u201d field in the client’s data control panel, you will find two options:<\/p>\n

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  1. Insurance Company:<\/strong>\u00a0Select from the available options the desired insurance agent.<\/li>\n
  2. Insurance Category:<\/strong> Choose from the available options for the client’s insurance category.<\/li>\n<\/ol>\n

    Beneath these two fields, you can input the client\u2019s insurance number in the \u201cClient Insurance Number<\/strong>\u201d field.<\/p>\n

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    Then click \u201cSave<\/strong>\u201c<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

    [\/vc_column_text][vc_message message_box_style=”3d” message_box_color=”sky” icon_fontawesome=”fas fa-book”]For more details about adding a new client check the following guide \u201cAdd New Client<\/a>\u201c<\/strong>[\/vc_message][vc_custom_heading text=”Cases for Configuring
    \nInsurance Category Settings and How Each Case Is Processed” font_container=”tag:h2|font_size:26|text_align:center|color:%2304306b|line_height:2″ use_theme_fonts=”yes” css=”.vc_custom_1711435940548{margin-left: 200px !important;background-color: #f6f9fc !important;border-radius: 4px !important;}”][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]<\/p>\n

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    Keep the following guidelines in mind to understand how the system calculates the co-payment for both the patient and the insurance company.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

    [\/vc_column_text][\/vc_column][\/vc_row][vc_row][vc_column][vc_custom_heading text=”Case 1: No maximum payment or discount” font_container=”tag:h3|font_size:22|text_align:left|color:%2304306b|line_height:2″ use_theme_fonts=”yes” css=”.vc_custom_1711436452343{margin-left: 120px !important;}”][vc_column_text]In this case, where co-payment percentages are defined for both the client and the insurance company, without setting a maximum payment or discount, the system automatically divides the total cost of the service\/product in proportion to the client\u2019s and insurance company\u2019s percentages.<\/p>\n

    For example:<\/p>\n

    Client: Adam (insured by the International Insurance Company \u2013 The First Category for International Insurance Company).
    \nProduct: Prescription Eyeglasses (with a cost of $500, categorized as a high-price product).
    \nCo-payment Percentage: Client (30%), Insurance Company (70%).
    \nDiscount: None
    \nMaximum Payment: None<\/p>\n

    \"\"[\/vc_column_text][vc_message message_box_style=”3d” message_box_color=”grey” icon_fontawesome=”fas fa-microscope”]<\/p>\n

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    Note and Explanation:<\/strong><\/p><\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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    We notice that the system automatically charged Adam ($150) and the insurance company ($350) in proportion to their co-payment percentages.<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n

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    [\/vc_message][vc_custom_heading text=”Case 2: There Is a Maximum Client Co-payment with No Discount” font_container=”tag:h3|font_size:22|text_align:left|color:%2304306b|line_height:2″ use_theme_fonts=”yes” css=”.vc_custom_1711439060572{margin-left: 120px !important;}”][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]In this case, where a maximum client co-payment is set without specifying a discount, the system charges both the client and the insurance company according to their respective co-payment percentages. If the cost exceeds the maximum client co-payment limit, the system ensures not exceed this limit by transferring the remaining portion of the total cost of the product or service to the insurance company.<\/p>\n

    Illustrative Example:<\/p>\n

    Client: Adam (insured by International Insurance Company).<\/p>\n

    Product: Prescription Eyeglasses (costing $500, categorized as high-priced products).<\/p>\n

    Co-payment Percentage: Client (30%), Insurance Company (70%).<\/p>\n

    Discount: None<\/p>\n

    Maximum Client Co-payment: Maximum co-payment of $100 (for the client).<\/p>\n

    \"\"[\/vc_column_text][vc_message message_box_style=”3d” message_box_color=”grey” icon_fontawesome=”fas fa-microscope”]<\/p>\n

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    Note and Explanation: Adam<\/strong> an amount that does not exceed the specified maximum co-payment limit ($100) when it was expected to charge her according to her co-payment percentage ($150). Meanwhile, the insurance company covered the remaining cost of the product ($400).<\/strong><\/p><\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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    [\/vc_message][vc_custom_heading text=”Case 3: There is a maximum insurance company contribution limit, and there is no discount” font_container=”tag:h3|font_size:22|text_align:left|color:%2304306b|line_height:2″ use_theme_fonts=”yes” css=”.vc_custom_1711438891050{margin-left: 120px !important;}”][vc_column_text]In this case, the system charges both the client and the insurance company according to their respective co-payment percentages. If the cost exceeds the maximum insurance company contribution limit, the system ensures not to exceed this limit by charging the remaining cost to the client.<\/p>\n

    Example for illustration:<\/p>\n

    Client: Adam (insured by International Insurance Company).
    \nProduct: Prescription Eyeglasses (costing $500, categorized as high-priced product).
    \nCo-payment percentage: Client (30%), Insurance Company (70%).
    \nDiscount: None
    \nMaximum payment limit: Maximum insurance company contribution limit of $200.<\/p>\n

    \"\"[\/vc_column_text][vc_message message_box_style=”3d” message_box_color=”grey” icon_fontawesome=”fas fa-microscope”]<\/p>\n

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    Note and Explanation:<\/strong><\/p><\/blockquote>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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    In this scenario, you will notice that the system has charged the insurance company an amount that does not exceed the specified maximum contribution limit ($200) when it was expected to be charged according to its co-payment percentage ($350). Meanwhile, the client has been charged the remaining cost of the product ($300).<\/strong><\/p>\n<\/div>\n<\/div>\n<\/div>\n

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    [\/vc_message][vc_custom_heading text=”Case 4: There is a discount, and there is no maximum limit” font_container=”tag:h3|font_size:22|text_align:left|color:%2304306b|line_height:2″ use_theme_fonts=”yes” css=”.vc_custom_1711439913683{margin-left: 120px !important;}”][\/vc_column][\/vc_row][vc_row][vc_column][vc_column_text]In this scenario, where a discount is set for the client (typically, the discount is applied to the client and not the insurance company) without a maximum limit, the system loads the cost for both the client and the insurance company according to their respective co-payment percentages and then applies the discount to the client\u2019s co-payment percentage.<\/p>\n

    Illustrative Example:<\/p>\n

    Client: Adam (insured by International Insurance Company).
    \nProduct: Prescription Eyeglasses (costing $500, categorized as a high-priced product).
    \nCo-payment Percentage: Client (30%), Insurance Company (70%).
    \nDiscount: 10%
    \nMaximum Payment Limit: None.<\/p>\n

    In this scenario, we observe the following:<\/p>\n