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
- Insurance: Enter Insurance ID (not the name).
- Name: Enter part of the Insurance Name.
- Patient: Enter the Patient ID or use the Lookup icon to find the Patient.
- 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.
- Assignment: Select from the dropdown.
- Include Inactive: Select if you want to show all Active and Inactive Insurances.
- The Inactive Insurances will be highlighted in red.
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- 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.
- 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.
- 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.
- Billing Group: If the Insurance is in a Billing Group, select the group using the Lookup icon.
- Reporting Group: If the Insurance is in a Reporting Group, select the group using the Lookup icon.
- Credentialing Required: Select the checkbox to show only the Insurances where credentialing is required.
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- Address: Enter part of the Payer's address.
- City: Enter or lookup the Payer's city.
- State: Enter or lookup the Payer's 2 digit State.
- Zip: Enter or lookup the Payer's Zip Code.
- 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.
- Insurance Custom Field: If there was a Custom Field setup on the Insurance, you can search by that added field.
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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
- Filter for all Cigna Insurances in your Library.
- Filter for WC (Workers Comp) Insurances.
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Example of .csv file saved as type: Excel® Workbook (.xlsx)
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Example of PDF
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- 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.
- 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.
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- 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.
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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.
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- Add additional Insurance Addresses.
- Displays the Alternate Addresses that have been added.
- Select the Alternate Mailing Addresses link to add or modify the addresses.
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Products Panel
- Aetna Choice POS II
- Open Access Aetna Select
- Open Choice
- Out of Network Medical
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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.
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- Add or Delete panels.
- Select Save Current View.
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