Quick Guide: Adding and Editing Patient Insurance Information

1. Adding and Editing Patient Insurances

This guide will walk you through adding new insurance to a patient, adding an authorization, checking eligibility, editing a patient's insurance, and terminating a patient's insurance. Let's begin with how to add new insurance for a patient.

2. Insurance Details

First, go to Search Patient, find your patient, and select the radio button next to their name. Then, go to Edit Patient and click Insurance. Click Same as Patient to automatically populate the patient's first and last name. If the patient's demographic screen has a different name than the insurance card, do not click Same as Patient; manually enter the first and last name. Choose your Payor by typing the first three characters of the insurance for a list to populate.

3. Insurance Details Continued

If the insurance you're looking for is not in the dropdown, click the blue plus icon to add a new insurance company; this will pull up the Payer Master. Fill out the rest of the required information for Insurance Details, including Policy number, Start Date, and Category. Fill out the required information for Insured Details. Click Same as Patient to populate data from the Demographics screen. Anything populated in the Comments box will appear in box 80 on the UB04. Review the automatically populated dropdowns, as they default to Yes for ROI, or Release of Information, and AOB, or Assignment of Benefits.

4. Adding an Authorization

Click Save. After saving new insurance, more options are available. Click Auth#. On the popup, enter the required fields, including Auth#, Auth Units, Start Date, End Date, and CPT Code. Click the icon to choose a CPT code. Update the Procedure Code dropdown to the proper category. Enter the CPT code in the Search Procedure Code box and click Search. Check the box next to the Procedure Code and click Add.

5. Checking Eligibility

This will move the item under Selected Items List. Click Done. Enter any notes you may need and click Save. In the newly added insurance, there is another option available. Click Check Eligibility and click OK on the popup. Wait a few seconds, then you will see another popup; click OK. A View Eligibility box will appear under the Insured Details with the results. This box tells you the day the eligibility check was run and the status. Click the Eligibility Check Date to review the results. Click Add/View to enter a note or review your previous notes.

6. Editing and Terminating Insurance

To edit a patient's insurance, go to Search Patient, find your patient and select the radio button next to their name, then go to Edit Patient and click Insurance. Select the name of the insurance company. Select the company for the whole organization, not the patient's insurance company. Choose the Payor Name to edit the patient's insurance. Make your changes and click Update. To terminate a patient's insurance, follow the same initial steps, then select the Payor name. On the right side of the screen, enter an End Date and click Update.