The Policy Profile and the Case must be set up on the Patient.

• If there is another Policy Profile on the Patient, the Workers Comp Policy Profile must be set to Active instead of Default by deselecting the Default checkbox.

Add a Worker's Comp Profile

1. On the Patient Dashboard, select the Insurance/Employer Management link.

2. Select the Add New Insurance Profile button.

3. Select the Add New link.

4. Insurance: Search for the Workers Comp Insurance.

• If the WC Insurance cannot be found, look in the Insurance Library to see if it has been added (Workers Comp Insurance).

5. Policy: Enter the Policy number.

• In some States, this is a Social Security Number.

1. Select the Lookup icon as a short-cut to retrieve the Patient's Social Security number.

• If an SSN or Policy number is not required, use 999999999 which is a mandatory field.
• This displays in HCFA Box 1a or ANSI Loop 2010BA.

6. Group: Enter the unique Workers Comp Claim Number.

• Displays in HCFA Box 11 or ANSI Loop 2000B.

7. Group name: Enter a Group Name if applicable.

• Displays in HCFA Box 11c

8. Insured Relationship

• Patient Relationship to Policy Holder:

• 20-Employee/Attorney, (HCFA Box 4 or ANSI 2000B).
• If the Relationship is Self, leave as 18 Self and skip Steps 9 and 10.

9. Employer/Attorney: On the popup screen, select the Employer from the dropdown

1. Displays in HCFA Box 7 or ANSI Loop 2010BB (Address).

10. Employee/Attorney: Use the Lookup Icon to choose Employer/Attorney.
11. Select Save [F2].

Worker's Comp HCFA Fields

Learn More

Add a Workers Compensation to Insurance Library

Insurance Profiles Overview