Zdrovia tracks the two halves of insurance: who covers your patients, and what you are owed.
Navigate to Insurance in the sidebar (/dashboard/insurance). The page has two tabs: Claims Queue and Providers.
Providers
The insurers your clinic bills.
Adding a provider
| Field | Example |
|---|---|
| Name | Blue Cross Blue Shield |
| Short name | BCBS |
| Region | CA |
Providers are clinic-wide. Once one exists, it can be selected on any patient’s policy.
Patient policies
A policy attaches a patient to a provider. Policies live on the patient’s profile as an Insurance Policies card — see Patients.
Patients can add their own policy from the portal, which saves your front desk transcribing a card number over the phone.
The claims queue
The tiles at the top of the Claims tab filter the same list they count:
| Tile | What it holds |
|---|---|
| All claims | Everything |
| Pending | Submitted, no decision yet |
| Ready to collect | Adjudicated — money to chase |
| Appealing | Denied and under appeal |
| Denied | Denied, not being appealed |
| Paid | Settled |
Working a claim
Open a claim to record what happened to it:
| Action | What you enter |
|---|---|
| Record a payment | The amount the insurer paid |
| Record a denial | The reason for denial |
| Appeal | Moves the claim to Appealing, with an optional note |
| Add a note | Free-text context for anyone picking the claim up later |
A claim that is partly paid leaves a balance, which is what Ready to collect is counting.
Insurance and invoices
An insurance claim sits alongside the patient’s invoice, not instead of it. The patient’s own share stays billable to them while the insurer’s share is worked through the queue — so a partly covered visit is one invoice and one claim, not two invoices.
Tips
- Add your providers once, up front. Every policy after that is a dropdown rather than a typed insurer name, which is what keeps the claims queue groupable.
- Ask patients to add their policy in the portal before their first visit — it is faster and the card number is right more often.
- Work Ready to collect first. Pending claims are waiting on someone else; ready ones are waiting on you.
- Record the denial reason even when you are going to appeal. It is the only thing that makes a pattern of denials visible.