Quick Start: Entering Patient Insurance
There are three section on the patient's Billing tab
Guarantor Information
Assign the patient a guarantor only if the patient is not responsible for the bills, such as a child or when the patient has a "power of attorney". There is a list of all guarantor's associated with the Guarantor field. If Guarantor override is "Yes" then you will not be asked to assign this patient a guarantor if the age is <22. To make this patient a guarantor click Pat -->Guar button. To make a new guarantor record click the New Record.
Insurance Information
PracticeMaker® will allow a patient to have unlimited insurances. When an insurance is no longer used it is assigned a "Billing Priority" of "99". You NEVER need to delete a previously used insurance.
To add a new insurance click the Add Patient Insurance button and confirm your action.
- Listed by "not used" insurances get
the priority # of "99". The patient can have one primary,
secondary and tertiary insurance.
- Click in Ins Code and enter the code you assigned to the insurance you want. You can click the Pick List button to help you search for the insurance you want. If you still cannot find the company you want from this list you will need to create a new Insurance carrier record to be used for this patient. For this refer to the full Patients chapter in the PracticeMaker® manual.
- ID and Group needs to contain the policy numbers entered without dashes or spaces.
- Select the appropriate Rel (relationship) between the patient and the insured from the pop-up list. If you do NOT select “ Self” you must enter the subscriber’s first and last name in the Subscriber Information section of this screen.
- Ins Type is used to designate the “type of insurance”. For a Medicare patient’s secondary insurance select MG for a Medigap policy, or SP if it is an employer-supplementary insurance.
- Billing Priority tells you which is this patient’s primary (1), secondary (2) and tertiary (3) coverage. Only one insurance can be assigned to one of these numbers. “99” At present these numbers are only informational. When you assign a claim to a specific insurance this needs to be done in the Billing module when the invoice is created.
- If needed, complete the Subscriber’s Information fields.
- Required fields have a
next to
them.
Assign Benefits
This defaults to "Yes" For Signature on File the default is "B", or “block 12 & 13 signed on file”. Change this if needed. Release signed defaults to Yes. Date is made to be the creation date of the patient’s record AND the date the releases were signed. If this information is different, it should be changed!
Billing Information
In the Billing Information section complete all fields that are needed.
- In Bill First... select Patient or Insurance
- If your are creating a patient only invoice click Create Patient Invoice.
- To create an insurance invoice click Create Insurance Invoice.