Managing Patient Insurance Payers (Policies)

To add a new patient insurance policy, or to view the details of an existing policy:

1. Find the desired patient in the Patient List.
2. Double-click the row to open the Patient detail view.
3. Click the Payers tab.
4. If the Insurance Policies tab is not currently selected, click that tab to see the list.
5. To add a new policy, you can do any of the following:
   • Press <CTRL><N> on the keyboard.
   • Click the first icon in the toolbar for this tab.
   • Right-click the list and select New from the pop-up menu.
6. To view the details of an existing policy, just double-click the desired policy row in the list.

The Patient Insurance Policy detail view looks like this:

Notice that there are several tabs on this form:

• Main has fields for the basics, such as the Insurance Plan, coverage dates, type of services being billed, type of policy, and over-rides for co-pay settings inherited from the policy’s Insurance Plan. On this tab you also can see current aging and balance data.
• Managed Care Auths lists any authorizations. You can add new authorizations here, and view or edit the details of previously defined authorizations. For more information about Managed Care Authorizations see Adding and Changing Managed Care Authorizations.
• Claim Form contains fields that are needed to submit a claim, ranging from the Insured’s ID Number (Subscriber Number) to “Accept Assignment”. These are fields that you will probably recognize immediately from the CMS 1500 form.
• Patient Insurance Policy Attachments is a list of other documents associated with this policy. The most commonly attached document is a scanned copy of the patient’s insurance card, but there is no restriction or limit to the documents you can attach from this screen.
• User Defined Fields
• Change Log

See also: Understanding Insurance Carriers, Plans, and Policies