Patient Register: Insurance

Version 14.19
The Patient Register window merged with the Patient Chart for easier convenience with the creation of OP 19. Since the Help Center supports both OP 14 and OP 19, the account functions within the patient chart for OP 19 will still be referenced at the same Help Center locations as OP 14.

About Patient Account: Insurance

Path: Clinical tab > Patient Chart button > Insurance
Path: Practice Management tab > Patient Chart button > Insurance
Path: Billing tab > Patient Chart button > Insurance

The Patient Chart window maintains a patient’s account.  The Insurance window within the patient's chart displays the patient's insurance information.

Patient Account: Insurance Map

Number
Section
Description

1

Insurance button

The Insurance button displays the insurance information in the Patient Chart.

2

Insurance Information function buttons
The Insurance Information function buttons add, removed, edit and save insurance record information.
3
Guarantor
The Guarantor field links the guarantor to the patient account.  The Guarantor is the patient or patient's contact (when the patient is a minor) who is the responsible party for the medical bills and insurance coverage.  You can set the method that the guarantor will receive the medical statements in this field (mail, portal, credit card on file, hold).
4
Insurance Record List
The Insurance Record List displays the active, inactive, pending, and invalid insurance that are linked to the patient’s record.
5
Copy From button
The Copy From button copies a sibling's insurance record and attaches it to the patient’s insurance record. (see Copying Insurance Information From a Family Member).
6
Print button
The Print button opens the Patient Register Information Report window.  This window prints the patient’s demographics from within the patient registration.  Be certain to select the items to appear on the report before clicking the Print button.
7
Self-Pay button
The Self-Pay button clears the primary insurance and marks the default payer as self-pay.
8
Validate buttonThe Validate button validates the insurance for all the appointments in the tracking grid.
9
Insurance Information Panel
The Insurance Information panel contains the insurance information from the selected insurance record in the Insurance Record list. Once an insurance policy has been attached to a claim, it cannot be modified.  The Insurance Information panel contains the following tabs:
  • Edit Insurance Record: The Edit Insurance Record contains the insurance policy status, subscriber (patient name), subscriber ID,  group number, group name, VFC eligibility, and patient responsibility information.
  • Address/Employer: The Address/Employer tab contains the subscribers address returned from the insurance carrier via validation.  It also is where you can enter the subscriber's employer or school address.
  • Medical Benefits: The Medical Benefits tab dIsplays the office and lab capitation monthly amounts.
  • Pharmacy Benefits: The Pharmacy Benefits tab contains the pharmacy insurance information including patients name, birthdate, gender, PBM name, policy number, group number and plan name.
Version 14.10

About the Patient Register: Insurance Tab

Path: Smart Toolbar > Register button > Insurance tab

Whether a new patient is entering your practice or your practice is transitioning from paper to electronic records, creating a Patient Register record in the patient's chart is the first step in registering a patient in your database. The record assigns each patient a unique patient ID number, and automatically creates a Patient Chart for the patient.

Using the patient register you can:

  • Link Families
  • Confirm a new patient needs to be registered
  • Register a new patient
  • Print a patient’s demographics
  • Copy a sibling’s register record
  • Add relatives or contacts to a patient’s register record
  • Add, edit, copy or validate insurance
  • Add miscellaneous notes
  • Add privacy restrictions
  • View and add consent forms
  • View and add to the patient’s coordination of care
  • Change the family address.

The Patient Insurance Records tab sets up a patient’s primary and secondary insurance record.  In the Patient’s Insurance tab you can:

Patient Register: Insurance Tab Map

Number

Section
Description
1
Patient Registration Category Tabs

The Patient Register contains the following tabs:


2
Function buttons
The function buttons allow the user to print, create, delete, edit, save, and cancel the insurance information displayed or entered in the patient register.
3
Guarantor
The Guarantor field links the guarantor to the patient account.  The Guarantor is the patient or patient's contact (when the patient is a minor) who is the responsible party for the medical bills and insurance coverage.  You can set the method that the guarantor will receive the medical statements in this field (mail, portal, credit card on file, hold).
4
Insurance Record List
The Insurance Record List displays the active, inactive, pending, and invalid insurance that are linked to the patient’s record.
5
Insurance Information function buttons
The Insurance Information function buttons add, removed, edit and save insurance record information.
6
Copy Insurance Information button
The Copy Insurance Information button copies a sibling's insurance record and attaches it to the patient’s insurance record. (see Copying Insurance Information From a Family Member).
7
Print Report button
The Print button opens the Patient Register Information Report window.  This window prints the patient’s demographics from within the patient registration.  Be certain to select the items to appear on the report before clicking the Print button
8
Self-Pay button
The Self-Pay button clears the primary insurance and marks the default payer as self-pay.
9
Activate Card Reader
The Activate Card Reader button marks the card reader as active.
10
Insurance Information Panel
The Insurance Information panel contains the insurance information from the selected insurance record in the Insurance Record list. Once an insurance policy has been attached to a claim, it cannot be modified.  The Insurance Information panel contains the following tabs:
  • Edit Insurance Record:   The Edit Insurance Record contains the insurance policy status, subscriber (patient name), subscriber ID,  group number, group name, VFC eligibility, and patient responsibility information.
  • Address/Employer:  The Address/Employer tab contains the subscribers address returned from the insurance carrier via validation.  It also is where you can enter the subscriber's employer or school address.
  • Medical Benefits: The Medical Benefits tab dIsplays the office and lab capitation monthly amounts.
  • Pharmacy Benefits: The Pharmacy Benefits tab contains the pharmacy insurance information including patients name, birthdate, gender, PBM name, policy number, group number and plan name.