Patients 4 - Adding Employers and Insurance to Accounts


The Primary and Secondary tabs are the holding place for employers and insurance carriers within MacPractice. Click the green plus to enter the employers for a guarantor. You can search for an existing employer at the top of the new window or you can use the bottom portion of the window to add a new record to the database. You will notice that the only required field is the Employer Name. Once the employer has been added to the account, add the group number for the insurance carrier.

Now that the employer reference has been setup, click the green plus to add an insurance carrier to the guarantor/ Use the search bar to find an existing record or to create a new insurance carrier/ You might need to navigate to the Plan tab to make a new plan for the insurance carrier. If the record is locked, click the padlock in the bottom left corner. Click the green plus to add a new plan. You can set up more details for the insurance carrier in this window. However, this training session is just covering the basics of entering insurance. Please watch the Insurance Carrier series in the help documentation for more information.

Once you click save, the insurance company will be listed below. Enter in the Subscriber Number from the patient's insurance card. Select from the drop down box if you have entered the employer information. Linking the Employer and Insurance will automatically pull the group number into the insurance. Use the drop down box to select the correct plan for the patient.

You may also decide to track the insurance start, end, or renewal date. If your date of service does not fall between the start and end date for the insurance, you will not be able to create claims for those charges. If you decide to track start and end dates be sure they are entered correctly. Only enter an end date for an insurance if the patient's coverage actually terminates on a specific day. For example, in the event they switch insurances or lose coverage. The patient's annual coverage and deductible will renew. The renewal date is expressed in month and day as it occurs yearly, usually January first.

After linking the employer and the insurance, MacPractice will help by suggesting insurance companies for future patients.

If your guarantor has another supplemental insurance, you can simply click the plus button to add another insurance carrier here. You can have as many insurance companies associated to a guarantor as you need. If you need to remove an insurance, select it and click the minus button. MacPractice will archive the insurance on the patient if it has ever been used on this account. For example, if the patient had past insurance claims or payments. If the insurance is archived you can always retrieve it later. To retrieve archived insurance, click the Show Archived button and double click on the insurance in the list. 

If your patient has another guarantor, you may enter their information on the Secondary tab and any corresponding insurances or employers below.

Any information that you add to the insurance on the guarantor screen will carry over to the patient screen. For example, if you enter a subscriber ID on the guarantor tab, you will also see that subscriber ID on the patient tab. If the patient has their own subscriber ID unrelated to the guarantor, like with Medicaid and other carriers, you can override the subscriber ID here on the patient tab. The ID on the Patient will be used on claims instead of the guarantor number. Please just be aware if you do this, the link between the two numbers will be broken and new changes made on the primary screen will not update the patient ID number. To fix this, simply remove both numbers from the primary and patient screens and start over.

All insurances added for all guarantors on the account will appear under the patient's Insurance tab. The insurance companies will be billed in the order they appear here, so even if your secondary guarantor is the cardholder for the patient's primary insurance, you can resort or reorder them here by dragging them to the appropriate position. Since you can reorder the insurance on the patient, the person on the Primary tab may not be the cardholder for the primary insurance. As long as your insurance companies appear in the correct order under the patient screen, your insurance companies will be billed in the correct order within MacPractice.

You can also specify whether each insurance applies to this patient or not by using the enabled checkboxes. If the insurance listed does not apply to this patient, perhaps because it applies to other patients in the account, you may uncheck the enabled checkbox and this insurance won't be used for this patient.

Additionally, on the patient screen you should verify the patient's relationship to primary and relationship to secondary are set correctly/ This is the patient's relationship to the person on the Primary TAB, not the primary insurance. MacPractice lists the name shown on the primary tab so you can easily see who it is. If you set the relationship to self and the names on the patient and primary tabs do not match, the name will be displayed in red. You should pay careful attention to the relationship fields. If they are not set correctly it is possible your claims will not be processed correctly.

You can also enter the patient's copay amount on the insurance if you would like to track how much their copay is. The deductible and remaining coverage fields only apply if you will be using insurance estimating. Please review the insurance estimating section of the help page for more information.

You can scroll over to the right to see some additional information about the insurance, such as the subscriber name, employer, group number, and plan name on the guarantor tab will be displayed here. The start and end date for the insurance will be carried over from the guarantor tab if you entered them, or you can override them here on the patient. The medicare type field is used for electronic claims if medicare is secondary, allowing you to specify why medicare is a secondary carrier. If you need to have the EPSDT or family planning options printed on your claims you may check the appropriate checkboxes below. 

Once your insurance companies are entered for your patient's you may begin creating claims.


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