Client Profile: Insurance

Access to client insurance claims and insurance settings are viewable in two areas of the system:

The client profile, under the Primary Insurance section (near the bottom)
The client profile, clicking the Insurance tab on top

Client Profile

To view either primary or secondary insurance on file, locate the client profile by going to:

group Clients (left menu)
Click on the clients name, bringing you to their profile
Scroll down and find the Primary Insurance section
We've highlighed an example of a completed primary insurance policy below:

At the top, the primary policy:

If a client does not have insurance:

This section will be blank, click (top right of section):

If a client has insurance:

To make changes to the policy, click the pencil edit to edit the Policy or Insured section (top right):

To view or edit a Policy:

Click the pencil icon edit to view or edit policy details
Here you can view and edit various policy details for this client's insurance claims including:

Subscriber ID, Plan name, Group, Start and End date
Relation to insured
Referring physician name (CMS-1500 Box 17), NPI (CMS-1500 Box 17b) and role, as well as physician ID type and ID (CMS-1500 Box 17a [infrequently used])

Click manage_search next to policy to just view those details (cannot edit).

To add an insurance card:

Click beneath the policy section
Article: Uploading an Insurance Card / ID

Beneath that are:

Benefits Confirmations
Pre-Authorizations
And any expired primary policies:

Below Primary Insurance you will see Secondary Insurance as well as our Insurance eligibility checks feature.

To add a benefits confirmation:

Click the top right + in the section

To add a pre-authorization:

Click the top right + in the section

For either benefits confirmation or authorization:

If you've already entered details, it will look like below
Click edit to edit (or view) the details
Click delete to permanently delete
Click manage_search to view the notes (cannot edit)

To edit automatic claim creation settings (per provider):

Click (top right of section)
Then toggle on/off any provider, and click when finished

Insurance Tab (Client Profile)

Within every client Profile there is an Insurance (top tab) also dedicated to this. Click to load:

Open Insurance Claims

Open insurance claims are also accessible from this section. Each claim has a View option to the right, allowing you to see any client-specific claims in a single list.

Insurance Claim Settings

Here you can edit Private Pay as well as Automatic Claim Creation:

Insurance: Primary & Secondary

Client-specific insurance information, including Primary and Secondary details, can be viewed and updated here as well.

Primary Insurance

Don't have insurance entered?

You'll see a blank section like this. Click (far right) to add a client's primary insurance:

Have insurance entered?

You'll see the details listed here:

Options (top right):

Will create a new Primary Insurance Policy
Allows you to edit your existing primary insurance policy

Underneath, you can also edit and set Insurance Benefit Information and Pre-Auth/Certifications for this particular insurance policy.

Click the edit icon edit (far right) of either option to configure.

Insurance Benefit Information:

Here you can set specifics to a clients benefits like:

CPT specific benefits
Deductible amount / met
Usual Fee / Co-Pay
Pre-Auth/Cert Required?
Benefit verification number and dates
Any additional notes you wish to include

Pre-Authorization/Certification: