Encounter Policy Breakdown Panel

Encounter Policy Breakdown Panel

IdeaAccess to Add/Modify Insurance Policy is controlled by User Permissions.






Insurance and Patient Responsibility (Encounter Specific)

  • Name of the Responsible Party (Payer Name or Patient)
  • Hover-over shows Payer information
  • Click the Payer Name Link to go to the Add/Modify Policy screen where Policy information can be edited.
  • Card Received/Scanned: *This is a Premium Add-On Feature.
  • Policy Number
  • Group Number
  • Status of the claim: These are two of the most common.
  • Ready for Submission/Resubmission: If the Reference Batch is closed the claim will be in the next Claims Batch.
  • Hold Coordination of Benefits: Holding for current Responsible Party to pay. This status will automatically change when the payment is posted for the current Responsible Party.
  • Responsibility Date: The date that this payer became responsible.
  • Days that this payer has been responsible
  • Bill Date: The days since the claim was last billed
  • If the Responsible Part is a Collections Agency, the Bill Date will reflect the date that the Encounter was sent to Collections.
  • Days: Days since the claim was last billed
  • Verify (Eligibility): Shows the Eligibility Status and date it was last checked for the Payer. If there is not a date link, Eligibility has not been checked on the Encounter Level.
  • Balance: Shows the Balance that is in the payer's responsibility


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