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Insurance Information

This feature is used to capture insurance information for third-party billing. The information is needed for the 1500 Health Insurance Claim Form and for the Third-Party Billing module.

The feature is only available (to authorized users) if the Administration > Settings > Properties > Registry Settings > Third Party Billing Module option is enabled (selected).

Search for Insured Information

First, you need to search for the insured information for a patient.

To search for insurance information, select Patient > Insurance Information from the menu. (The link does not activate until a patient has been selected.) The Insured Search page opens with the following search criteria fields. Enter the information and click Search. The results appear in the Search Results section.

Field Description

First Name or Initial

Enter the patient's first name or initial.

Last Name or Initial

Enter the patient's last name or initial.

Insured ID Number

Enter the patient's insurance ID number.

If the patient appears in the search results list, click on the arrow button in the Select column for that patient. Otherwise, click the Add Insured Information button.

Add Insured Information

On the Insured Search page, either click the arrow button in the Select column for the patient if the patient if the patient is in the search results list, or click the Add Insured Information button. The Insured Information Add page opens. Enter the information and click Add Insured Information to save it.

The fields and options on this page are as follows:

Field Description

Health Plan

Select the name of the insured's health plan from the drop-down list. This field is required.

ID Number

Enter the patient's health plan ID number. This field is required.

Health Plan Group ID

Enter the health plan group ID number.

Plan/Program Name

Enter the plan or program name.

First Name

Enter the first name of the insured. This field is required.

Middle Initial

Enter the insured's middle initial.

Last Name

Enter the insured's last name. This field is required.

Date of Birth

Enter the insured's date of birth. This field is required.

Gender

Select the insured's gender.

Employer/School Name

Enter the insured's employer or school name.

Address 1

Enter the first line of the insured's address. This field is required.

Address 2

Enter the second line of the insured's address.

City

Enter the insured's city. This field is required.

State

Select the insured's state from the drop-down list. This field is required.

Zip Code

Enter the insured's zip code. This field is required.

Phone

Enter the insured's phone number.

Currently selected patient record on insured's plan

Any patients currently included on the insured's health plan are listed; select the checkbox to the left of the patient's name to remove them from the health plan. Select Child, Spouse, Self or Other for each listed patient.

Is Primary

Select this option if the health plan is the primary insurance for the listed patient(s).

After entering the information and clicking Add Insured Information, the Insured Information details page opens with the information you entered on the previous screen. Click Edit to edit the information or Back to return to the previous page.

Edit Insured Information

Before editing the insured information for a patient, you need to search for it. In the search results list, click the arrow button in the Select column next to the patient's name. The Insured Information details page opens. Click Edit. The Insured Information edit page opens. Make any necessary changes and click Save. The Insured Information details page reappears. Click the Back button to return to the main Insured Information page.

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