Payer Information (Patient)

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Information

Payer Information


  1. Chose Insured or Non Insured
  2. Payer Name
  3. Pick applicable preference
  4. Click box to make active
  5. Click Add

  6. Member( clinic Reference)
  7. Insurance ID (REQUIRED FIELD)
  8. Type (Clinic Reference)
  9. Group Number
  10. Co-Pay($) (will populate an alert with ($) amount when checking in from clinic Dashboard)
  11. Co-Insurance(%)
  12. Relation (depending on who is selected information is pulled from General Information)
  13. Fields 12 – 21 only active in Relation is not SELF
  14. First Name (depending on who is selected information is pulled from General Information)
  15. Middle Name (depending on who is selected information is pulled from General Information)
  16. Last Name (depending on who is selected information is pulled from General Information)
  17.  DOB (depending on who is selected information is pulled from General Information)
  18.  Sex (depending on who is selected information is pulled from General Information)
  19. Street Address (depending on who is selected information is pulled from General Information)
  20.  City (depending on who is selected information is pulled from General Information)
  21.  State (depending on who is selected information is pulled from General Information)
  22.  Zip (depending on who is selected information is pulled from General Information)
  23. Phone (depending on who is selected information is pulled from General Information)
  24. NPI Number( not used. Treating provider NPI pulls from user set up)

Authoriztions

Insurance Authorizations

  1. Authorization Number – Reference number
  2. Authorization Units – Allowed visits
  3. Authorized from – Beginning date
  4. Authorized to – End date
  5. Auth Active – Only one authorization range can be active at a time
  6. Save
  7. Add – Clears fields to enter a new authorization if in edit mode.
  8. Authorization List – History of insurance authorizations for patient.
  9. Send Auth. in Edi- Will include Authorization number in Electronic Claim (only send if insurance requires, over rides other references)