Adding Insurance Plan to a Patients Profile:
1. Navigate to Patients.
2. Search for and select the patient’s profile.
3. Select the Insurance tab.
4. Click Add Insurance.
5. Enter the Group or Plan Name.
6. Select the Payer from the dropdown.
7. Enter the Group ID.
8. Set this insurance plan as the patient’s Primary, Secondary, Tertiary, or Other insurance.
Note: If the patient already has an active primary insurance plan in the system, the system will automatically change the Set As option to Secondary, and so on. Make sure that what the system has recognized is correct.
9. Enter the Insured ID or Policy #.
10. Enter the Policyholder Relation to Patient.
11. If the policyholder is not the patient, enter the policyholder’s information.
12. Enter the start date, term date, and any reset date, if you’d like.
13. Click NEXT.
14. Add the optional Copay & Coinsurance information. Note that the Service Types you have available to choose from are those that you added in Settings > Practice Settings > Practice Information > Billing Information.
Note: The percentage of coinsurance that should be entered is the patient’s responsibility, not the payer’s. So if the patient is responsible for 20% of the payment, enter 20% in the coinsurance section.
15. Click NEXT.
16. Add the optional Deductible & Max Out of Pocket information.
Note: If you are using Automatic Calculation of Patient Responsibility, you should make sure to enter copay, co-insurance, deductible, and max out-of-pocket information. The automatic calculations on the ledger are based on the information you enter here.
17. Enter visit limit information if you’d like.
18. Click SAVE.
Once you’ve saved the patient’s insurance plan, you can edit the plan to include covered and non-covered services.
1. Choose the insurance from the patient’s profile.
2. Click EDIT.
3. Select the Coverage tab.
4. At the bottom of the slideout, click
Add Covered Service
or
Add Non-Covered Service
. We’ll add a non-covered service, but the process is similar for a covered service
5. Choose Service Type or Procedure Code.
- Service types are those that you chose in Settings > Practice Settings > Practice Information > Billing Information. For example, if your practice offers acupuncture but the insurance plan doesn’t cover any acupuncture services, you can indicate that by choosing the service type rather than each of the individual acupuncture procedure codes.
- Procedure codes are individual services entered by their CPT® codes.
Note: You can add both service types and procedure codes.
6. Click SAVE.