Entering Patient Insurance

This field is required. Click the arrow beside this field and select the name of the payor for the patient.

If a patient has multiple insurance payors, enter the sequence you want the billing process to use this payor information (1=primary, 2=secondary, 3=tertiary, and so on).

This field is required, but Enterprise Edition does not populate the list until you select a payor. Click the arrow beside this field and select the plan name associated with the payor.

The name of the insurance group's plan. This field is editable.

The group number associated with the plan. This field is editable.

If the payor selected has specific coverage dates, enter the Begin and End dates. Otherwise, leave the End date blank for continuous coverage during the admission encounter. The Begin date is required.

Select this check box if the patient has authorized your agency to release insurance information when requested.

Select this check box if the patient has authorized your agency to send payment directly to your physician or facility.

This check box will appear if Medicaid is selected as the Payor. Select this check box if the patient has applied for Medicaid but the Medicaid number has not yet been issues. The selection will appear on the HIS Report but will not flow to Billing.

Enter the policy number for the insurance payor and plan selected.

For Medicare payors, enter the Medicare Beneficiary Identifier (MBI). The MBI field is only available for payors that have the Payment Source set as "Medicare A" (in Master Files | Payors / Plans | Payors).

If you have a current authorization number, enter it here.

If you have any other authorization number, enter it here.

o     If the patient has a medicaid billing number, enter it here.

o     If the patient has a cap for medicaid benefits, enter it in the Benefit Cap $ field. Enter 0 for no cap.

Enter any additional notes.