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Primary & Secondary Tab - Insurance

To add a new insurance company to the record, click the plus sign near the upper right corner of the Insurance table. This will bring up a list of Insurance Company references. Search for a carrier, click on the record to highlight it and press Select to add it to the account. If the record is not present, use the plus button to create a new one on the fly. Certain User Group Privileges may also be set to restrict a staff member's access to to adding references on the fly, requiring new records to be created in references
There are a number of additional fields to fill out once insurance is selected. These columns may be rearranged by clicking and dragging the column headers. 
  • Enter the Subscriber #. If the insurance assigns specific identification numbers to each patient covered by an insurance (for example, the general subscriber number is 12345, but each patient has an identifier added to the number, such as 12345-A, 12345-B, 12345-C and so on), that information is entered on the Patient tab, not here.
  • If the insurance is provided through the Employer, select them from the pop-up menu. The information will be populated from the Group # field in the Employers table.
  • The Plan can be selected from the drop down box. If the patient's plan is not available in the dropdown, a new plan can be added to an insurance company in the references
  • The Start Date is the date the subscriber first gained this insurance. If the specific date is unknown, it is sufficient to enter a rough approximation, such as 1/1/2017. This information is not reported on claims, but it is used to allocate balances between the Insurance Portion and Patient Portion.
  • Enter the month and day coverage refreshes in the Renewal Date field. MacPractice calculations assume the renewal is 01/01 if no date is entered.
  • The End Date field should only be used if coverage terminates. This field is rarely filled out when first adding insurance to a patient's record. Entering a date may cause problems, such as the insurance amounts not refreshing in MacPractice on the date of renewal. 
    When the coverage is terminated, enter the date and then press the minus to archive the policy. If this date is not entered, an insurance company will still appear in lists or may show for claims
International Settings:
  • If localization settings are enabled for Canadian claims, a Policy # field will replace the Group #.
  • The Division/Section and Sequence/Version fields will only be visible to CDA claim users. For more information on these fields and CDA claims, please see our CDA documentation.
Deleting and Archiving Insurances 
To remove an insurance from this table, click the minus button. An alert appears that the insurance will be deleted; if any claims exist for the insurance, it will be archived.

If the subscriber has any archived insurance records, that will be indicated above the insurance table. Click the Show Archived button to view a list of the archived insurance records. A new window will open, displaying past insurance records. Double click an entry in this list to retrieve it.

Using Insurance 
Each insurance record can be enabled or disabled on a per-patient basis in the Patient Ability > Insurance tab. In a family account, patients can use or ignore the active insurances as well as change the order of coverage. 

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