Keeping a patient's insurance updated is important to avoid problems with your billing. To update your patient's insurance, navigate to your patient's chart (Navigation Bar > Patients > Patient List > Click on Chart ID).
Navigating to Patient Insurances
First, make sure that the 'Demographics' tab is active on the left hand side navigation.
Your patient's profile should appear.
Underneath the patient basic information summary, select the 'Insurances' tab to view all the insurance options that can be entered into the drchrono EHR.
Within the 'Insurances' tab, there are six insurance options that can be entered in the drchrono EHR: Primary Insurance, Secondary Insurance, Tertiary Insurance, Auto Accident Insurance, Worker's Compensation, and Durable Medical Equipment (DME). Select the insurance option that will be changed and you'll be presented with editable fields to enter your patient's insurance information.
Primary insurance is the most common insurance used by most practices. Under the primary insurance tab, you'll have several fields to enter your patient insurance information:
- Subscriber is the Patient: This checkbox indicates if the subscriber or policyholder is the patient. If the patient uses a parent or spouse's insurance, this box should be unchecked.
- Insurance Company: This is the name of the insurance company that covers the patient. Search for the insurance company using the search box. When the insurance company is found, the box below will auto-populate with the address of the insurance company.
- Carrier Payer ID: Every carrier has a unique five-digit payer ID. This is required in order to collect on each claim. The 'Carrier Payer ID' field will be auto-populated when an insurance company is selected from the insurance company search box or can be manually entered.
- TPL Code: TPL (Third Party Liability) refers to the legal obligation of third parties to pay part or all medical expenses under a Medicaid state plan. This number is used for Coordination of Benefits (COB) Medicaid benefits.
- Insurance ID Number: Policy number of the insurance. Can be shown as ID Number, Policy Number, Member ID, Member Number on a patient's insurance card.
- Insurance Group Name: If the patient purchased insurance through an employer, they will belong to an insurance group. The name of the group often does not appear on the insurance card and is not necessary after entering the insurance group number.
- Insurance Group Number: The group number associated with the patients' insurance.
- Insurance Plan Name: Name of the insurance plan provided on the patients' insurance card.
- Insurance Plan Type: The type of insurance that the patient holds. The following options are available for selection:
- Automobile Medical
- Blue Cross/Blue Shield
- Commercial Insurance Company
- Dental Maintenance Organization
- Exclusive Provider Organization (EPO)
- Federal Employees Program
- Health Maintenance Organization (HMO)
- Health Maintenance Organization (HMO) Medicare Risk
- Indemnity Insurance
- Liability Medical
- Medicare Part A
- Medicare Part B
- Mutually Defined
- Other Federal Program
- Other Non-Federal Program
- Point of Service (POS)
- Preferred Provider Organization (PPO)
- Title V
- Veterans Affairs Plan
- Workers' Compensation Health Claim
- Insurance Claim Office Number: If the patients' insurance card includes the phone number of the office's support line, you may enter that number here. This number can be used to call the insurance company to check on the status of the claim.
- Number of visits allowed per year: If the patient is limited by number of visits, you may enter than number here.
- Card Issue Date: The date of issue found on the patient's insurance card.
- Primary Insurance Notes: Any supplementary notes on insurance can be entered here.
- Insurance Photos: You may upload images of the patient's insurance card (both front/back) for verification purposes.
Once you have made the necessary changes please select the 'Save Demographics' button at the bottom to save the changes you have just made.