We are currently updating the OP Help Center content for the release of OP 14.19 or "OP 19". OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Create a New Insurance Record

Version 14.19
Path: Clinical, Billing, or Practice Management tab > Patient Chart button

Overview

In this section you will find instructions on adding an insurance to the patient record.

Add an Insurance Record

  1. Access the Patient Chart using the path above.
  2. Search for and select the patient.
  3. Click Insurance
  4. Click the Add buttonto start a new record.
  5. In the Adding Insurance Record tab, enter the following information: (the fields highlighted in red are required to save the insurance record)

  • Insurance Policy Holder: Use the drop-down in the first blank red field to select the policy holder. The policy holder must be listed as a contact in the patient's chart in order to see him.her listed in this drop-down.
  • Sex/birth date: Select the radio button to select the gender of the policy holder, and enter the policy holder's date of birth. Depending on who the policy holder is, this could be that of the parent or the patient in some specific insurance cases.
  • Patient Rel to guarantor: Use the drop-down to select the relationship of the patient to the policy holder (e.g., child, self, mother, father, spouse, etc.). 
  • Insurance Carrier: Click the ellipsis button to select the insurance from the Insurance Carrier Lookup window.  
  • Subscriber ID: Enter the Subscriber ID number obtained from the patient's insurance card or other source.
  • Group number and Group name (if applicable).
  • Patient responsibility (if applicable) and Copays (if applicable).  
  • Enter any applicable policy information in the Policy Status section of the window, as follows:

  • Status (Default is set to Active).
  • Validated
  • Effective
  • Terminated (not applicable when initially entering a new record).
  1. Select the Patient Responsibility Guarantor and the Statement Method located at the top of the window using the drop-down fields.

  1. Located below the Patient Responsibility Guarantor and Statement, click in the Ranking field next to the newly entered insurance and select from the following ranking options:

  • P: Primary
  • S: Secondary
  • T: Tertiary 
  • C: clear the ranking
Note: Ranking the insurance saves the new insurance record. 
Version 14.10
Path: Smart Toolbar > Register Button

Overview

In this section you will find instructions on adding an insurance to the patient record.

Add an Insurance Record

  1. To open the Patient's Insurance Record click on the Insurance button.
  2. Search for the patient in the Search box.
  3. Click on the Insurance tab   .
  4. Click the Insert Record button in the middle tool bar to start a new record.

Under the section Adding New Insurance Record, enter the following information in the red fields:

  1. Insurance Policy Holder - Click the dropdown button to select the relationship of the policy holder to the patient (e.g., first relative/guardian). If the policy holder has been entered in the patient's Contact record, their last and first name will appear in the dropdown.
  2. Sex - Click radio button to select the gender of the policy holder (not the patient).
  3. DOB (Date of Birth) - Depending on who the policy holder is this could either be the child's date of birth or parent.
  4. Patient Rel to guarantor - Click the dropdown button to select the relationship of the patient to the policy holder (e.g., child, self, mother, father, spouse, etc.).  

Patient Register: Insurance Record

  1. Insurance Carrier - Click the Insurance button  to select the insurance from the insurance carrier look up window.  

Insurance Record: Insurance Carrier

  1. Subscriber ID - Input the Subscriber ID number, Group number (if applicable), and Patient responsibility (if applicable).
  2. Copays - Enter any copay obligations.  

Insurance Record: Adding Subscriber Information/Copay Obligations 

  1. Enter any applicable policy information in the Policy Status section of the window, located in the upper right corner, as follows:
  • Status (Default is set to Active).
  • Validated
  • Effective
  • Terminated (not applicable when initially entered a new record).

Insurance Record: Policy Status

  1. Select the Financial Guarantor for the family and the Statement Method located at the top of the window using the dropdown.

        Insurance Record: Statement Method

  1. On the top part of the window, click in the Ranking field to view ranking options. Choose P- Primary, S- Secondary, T- Tertiary, or C- to clear the ranking. This will save the insurance policy for the patient. 

Insurance Record: Ranking

  1. Click the Red X buttonto close.