Add Insured or Payer Policy

The Insurance Info tab is used to manage your patient’s insurance policy information. It is used to add and edit insurance payers and insured party information while creating a new patient or after the patient has been saved.

1. Select Patient > Patient.

2. Use the Search field to search through your patients. 

   Place a check in the “Include inactive patients” box to include inactive patients in your search results.

3. Select the Patient.

4. Click the Insurance Info tab.

5. Click the Add New button or click on the arrow and select which type of payer to add. (e.g., Primary, Secondary or Tertiary).

6. Add the Insured Party by either selecting the Existing Insured (for existing patients) or Creating A New Insured.

   1. Creating a New Insured party?

      1. Check whether the patient is the insured or not.

      2. Use the Patient Relation to Insured drop-down menu to specify the patient's relationship to the insured. 

      3. Enter the Contact Info.

      4. Expand the Employer Information and begin adding any applicable information. 

7. Select the Payer Info tab near the top of the window.

8. Set the Priority for this payer using the Priority drop-down.

9. Use the Policy Type drop-down menu to specify the policy type for this payer.

10. Use the icon to locate the Payer. 

    If the primary clearinghouse connection does not support eligibility, you can use our "Check eligibility using a different payer ID" option. This is particularly useful for scenarios such as Independent Physician Associations (IPAs) in California that utilize distinct payer IDs for claims processing and eligibility verification.

11. Optional: Select the "Check eligibility using a different payer ID" checkbox and use theicon to locate your Eligibility Payer.

12. Enter the Member & Group ID.

13. Enter the Copay, Co-insurance,  Deductible, & Out of Pocket Max.

14. Enter the Effective Date & the Termination Date.

15. Click Add.

16. Want to check Eligibility for the payer?

    1. Click the Eligibility link.

    2. A Check Eligibility window will open.

    3. Use the Insurance Policy drop-down menu to select which payer to check eligibility for.

    4. Use the Service Type drop-down menu to select the eligibility type.

    5. Enter the Service Date Range.

    6. Click Check Eligibility.

    7. Optional: Print a copy of the eligibility report by clicking the  button.

    8. Click Close once finished viewing the report.

       Any errors or warnings related to the last eligibility check performed will display a   icon next to the payer. You can review the error message and recommend steps to correct the issue.

17. Click Save.