Insurance Library Overview

Libraries > Insurances

List of Insurances Screen

Filter Criteria Panel

Use the Filter Criteria to find an Insurance/Payer or a Type of Insurance.

• After entering the Filter Criteria, select the Search button.

Filters

1. Insurance: Enter Insurance ID (not the name).
2. Name: Enter part of the Insurance Name.
3. Patient: Enter the Patient ID or use the Lookup icon to find the Patient.
4. Type: Select the Type from the dropdown.

• Example of Type: Find all of the Workers' Comp Insurances.

• Using the Type Filter, select Workers' Comp.
• Select the Search button.

5. Assignment: Select from the dropdown.

• All, Y, or N

6. Include Inactive: Select if you want to show all Active and Inactive Insurances.

• The Inactive Insurances will be highlighted in red.

7. Claims Payer ID: Enter or lookup the Claims Payer ID.

• If using the Lookup icon, for Type, select Professional or Institutional from the dropdown on the next screen.

8. ERA Payer ID: Enter or lookup the ERA Payer ID. (This may be the same as the Claims Payer ID, but is often different.)

• If using the Lookup icon, for Type, select Electronic Remittance from the dropdown on the next screen.

9. Eligibility Payer ID: Enter or lookup the Eligibility ID.

• If using the Lookup icon, for Type, select Eligibility from the dropdown on the next screen.

10. Billing Group: If the Insurance is in a Billing Group, select the group using the Lookup icon.
11. Reporting Group: If the Insurance is in a Reporting Group, select the group using the Lookup icon.
12. Credentialing Required: Select the checkbox to show only the Insurances where credentialing is required.

13. Address: Enter part of the Payer's address.
14. City: Enter or lookup the Payer's city.
15. State: Enter or lookup the Payer's 2 digit State.
16. Zip: Enter or lookup the Payer's Zip Code.
17. Claim Status Payer ID: Enter or lookup the Claim Status Payer ID.

• If using the Lookup icon, select Type, Claim Status, on the next screen.

18. Insurance Custom Field: If there was a Custom Field setup on the Insurance, you can search by that added field.

Print a List of Insurances in the Library

In the Filter Criteria panel on the Insurance screen, there are two icons that can be used to download the Insurances.

• Excel (CSV); once downloaded, save as an .xlsx document.
• PDF

Use the Filters to narrow your search

• Examples

• Filter for all Cigna Insurances in your Library.
• Filter for WC (Workers Comp) Insurances.

Example of .csv file saved as type: Excel® Workbook (.xlsx)

Example of PDF

Add an Insurance to the Library

• To avoid duplication, always search for an Insurance/Payer before adding a new Insurance.

• Example: Search for Blue Cross by Name

• In the Name field, try Blue, Blue Cross, BC, BCBS before adding it.
• Select Search.

• If the Insurance is not found, select the Add button to create a new Payer.

Open the Insurance Dashboard

Select an Insurance ID to open the Insurance Dashboard.

Modify an Insurance

• Open an Insurance in the list by selecting the ID in the Insurance column.

• Overall View of the Insurance Demographics and Settings.

• Select the Modify link to make changes to the Insurance information.

Receipts Link

• Select the Receipts link to view all the receipts attached to the selected Insurance.

• The Receipts link opens the Receipt History screen.

Provider Credentialing Panel

• This panel only displays when the Credentialing Required checkbox is chosen on the Insurance.
• Shows the credentialing status of all Providers for this Insurance.
• To change a Status, select the Provider Credentialing link.

Enrollments Panel

• Displays the Enrollments for the Payer
• Enrollments can be created in this panel.

• Select the checkbox and select the Create Enrollments button.
• Or select the Create Enrollments link.

• The Existing Enrollments column shows the number of Enrollments for this Payer.

Alternate Mailing Addresses Panel

• Add additional Insurance Addresses.

• Displays the Alternate Addresses that have been added.
• Select the Alternate Mailing Addresses link to add or modify the addresses.

Products Panel

• Add Insurance Products

• Examples:

• Aetna Choice POS II
• Open Access Aetna Select
• Open Choice
• Out of Network Medical

Insurance IDs and Cross Codes Panels

• Using Cross Codes and Insurance IDs allow tweaks to the claim output based on the Insurance, Provider(s), Facility(s), and Procedure(s). Contact Support to add these.

• Example: A Payer needs a different Taxonomy Code than the one in the Billing/Pay To Library.

Fee/RVU Management Panel

• Select the Plus icon to see all Fee, Allowed, and RVU Schedules that are attached to this Insurance.
• To see all the Fee/RVU Schedules, click the Fee/RVU Management link.

Dashboard Controls

• Add or Delete panels.
• Select Save Current View.