Insurance Library Overview

Insurance Library Overview


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.
  1. Assignment: Select from the dropdown.
  • All, Y, or N
  1. Include Inactive: Select if you want to show all Active and Inactive Insurances.
  • The Inactive Insurances will be highlighted in red.

  1. 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.
  1. 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.
  1. 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.
  1. Billing Group: If the Insurance is in a Billing Group, select the group using the Lookup icon.
  2. Reporting Group: If the Insurance is in a Reporting Group, select the group using the Lookup icon.
  3. Credentialing Required: Select the checkbox to show only the Insurances where credentialing is required.

  1. Address: Enter part of the Payer's address.
  2. City: Enter or lookup the Payer's city.
  3. State: Enter or lookup the Payer's 2 digit State.
  4. Zip: Enter or lookup the Payer's Zip Code.
  5. 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.
  1. 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.


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


Dashboard Controls

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




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