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Creating a Patient Policy

The insurance billing workflow begins by entering patient insurance information inside their profile. This is done by setting up a new Insurance Policy.

An Insurance Policy is your patient’s health coverage. The policy or plan they’ve purchased from an insurance company or any other third party coverage they may have. Once an Insurance Policy has been created, it can be attached to any appointment covered by that specific insurance payer.

To add a new Insurance Policy for a patient, you can begin from two main areas; The Patient’s Profile or from their Appointment.

From the Patient Profile

From the patient Profile, you can begin by heading into the Billing tab and then clicking into Insurance Policies. Use the “New Insurance Policy” button to get started:

From the Appointment:

If you would like to enter a patient’s insurance information from the main schedule, follow the steps below:

  • Click on the patient’s appointment on the Schedule
  • In the Appointment window, scroll down and click to open the Insurance Info area
  • Click on the “Add Policy” button, and then select “Add New Policy”

Regardless of which way you start, the process from here is the same.

First up, select the insurance payer for the patient:

Here’s our handy guide if you need to create a new insurer:  Creating an Insurer

Next, give the insurance policy a name – this is internal and should be useful in identifying the policy.

  • The only mandatory information is the Claim Number.  For insurers who don’t use claim numbers, you can use the patient PHN or another identifier.

  • Enter any other information you’d like to record or track on the policy.  You can always return to this later to fill in more details.

  • You can enter default billing codes here, if appropriate. For insurance claims where you bill more than one item or area of treatment, you can see under all the codes you’ve added “Add Additional Billing Codes.” This allows you to add on as many billing items as you’re needing. And you can also “Add Diagnosis” and “Add Modifier.”

  • All of the default codes will automatically load to an appointment when you add this insurance policy.

Click Save, and you’re all set. The new insurance policy will now show up under the patient’s Insurance Policies area.

  • Or in the Appointment window:

Further Reading:

Booking an Insured Visit

Submitting Invoices by Paper

Submitting Invoices through a Portal

Receiving an Insurer Payment

Hope this helps!