You can enter Primary, Secondary and Tertiary information here as well as enter and track Deductibles and Maximum Allowables.
Click Insert to add an insurance company for this patient.
Sequence: Primary, Secondary, or Tertiary will automatically be completed for you. However, you can change this if necessary.
Ins Code: Select the insurance company from the look-up folder . This will refer to the Insurance Master List. Select the desired insurance company here. If you need to add the insurance company click Insert and complete applicable fields.
Once the insurance company has been selected, enter the patients Policy Number and Group Number if applicable.
Relationship: Select relationship to patient. At this point you will have the opportunity to copy over the Primary or Secondary Billing Party Information if applicable. This will automatically complete the Insured Information fields from the billing party information.
Insured Info [if not the same as patient]: If this was not automatically completed by selecting the billing party, manually enter last name, first name and MI as well as Address, Phone#, Date of Birth, Sex of the insured, Marital Status and Work Status.
Insured Employer Info: If this information was not automatically completed by selecting the billing party then manually enter the Name, Address, etc. for the insured’s employer.
Note: You can enter any notes specific to this patients insurance, policy provisions etc.
Default Co-Pay Amount: You can enter a dollar amount to automatically split out the patient’s responsibility when entering charges. NOTE: If you enter a default amount it will overwrite any %’s you enter.
Default Co-Pay %: Enter a default % here to split out the patient’s responsibility for charges that are not designated as Basic, Major or Preventative. CDT codes that are not designated in any of the three categories will be split by this default %.
Basic/Major/Preventative Co-Pay %: Enter co-pay percentages for each type of CDT category to split the patient’s responsibility out appropriately when entering charges. NOTE: You must set up your CDT codes and select one of the three Code Categories for this option to work.
Deductibles: Enter the annual deductible amount for this ins company in Deductible Amount. You can also enter any Applied Other; which is any part of the ded which was met elsewhere [i.e. another doctor, etc.] As you enter payments and apply any amount to the deductible it will automatically tally in the Applied to Date and Total Applied fields. Select a Deductible Type; Calendar Year, Fiscal Year or Lifetime and enter the date range as applicable.
Maximum Amounts: Enter the annual Maximum Allowable amount for this ins company in Max Allowed Amount. You can also enter any Applied Other; which is any part of the max which was met elsewhere [i.e. another doctor, etc.] As you enter payments it will automatically tally in the Applied to Date and Total Applied fields for this insurance company. Select a Max Type; Calendar Year, Fiscal Year or Lifetime and enter the date range as applicable. To recalculate applied mamimums click , this will calculate all payment made by the selected insurance company for visits for the date range applicable to the maximum limitation.
Click OK to save the information for this insurance company. Repeat the above steps for Secondary and Tertiary Insurance data if applicable.
Once insurance information has been added you can preview the Insurance Information on the right side of the patient information screen.