Billing/Insurance

Insurance Entry

From Check In Window, click into the Insurance row
From Patient's Chart, click the 3 dots in the top right corner, select Insurance

Choose Auto Accident, Worker's Comp, Travel Ins if appropiate
Choose Sign Up Without Insurance if the patient is paying out of pocket
Choose Enter Insurance Info if the patient has medical insurance

Medical Insurance Form Details

1. Enter insurance provider name, member ID, group number (if available)

2. Select patient's relationship to the subscriber of the insurance plan

3. If patient is subscriber, enter in the patient’s name, date of birth, address, and sex assigned at birth, then click save insurance

4. If patient is not subscriber
   Enter in the subscriber’s name, date of birth, address, and sex assigned at birth
   Enter in the patient’s name, date of birth, address, and sex assigned at birth
   Click save insurance

5. Real Time Eligibilty (RTE) check will run

6. If an Independent Physician Association (IPA) is found, it will be suggested to the user to enter in step 1

Real Time Eligibilty (RTE) Results

Specific steps to proceed

1. Please enter in the correct id.
   This is an indication that the Member ID is entered incorrectly, please review

2. RTE found an associated IPA: Name. Please select the IPA.
   This is a notice to enter the IPA listed in the yellow banner in the respective field

3. RTE found an associated IPA: Name. Please make sure the correct IPA has been selected.
   This is a notice that the current IPA selected in the form is incorrect, and to change to the one in the yellow banner.

4. Your insurance coverage is inactive. Please submit active coverage.
   This is a notice that the insurance details entered is no longer an active plan. Request current insurance information from the patient.

Unable to Verify Insurance

This means that the RTE was not able to connect to the Insurance company to verify the insurance in real time given the information entered. Users should verify the information entered into all steps outlined above is correct.
A copay will not generate to be collected at check in, but users can proceed

Your insurance is all set up

This means that the RTE was able to successfully verify the insurance in real time with the information provided.
If there is a copay associated with the patient's plan for the type of visit, one will be suggested in the check in flow.
NOTE: A successful verification of insurance does not guarantee the insurance if In-Network the the facility.