Insurance (Payor)

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In This Section

Client

  • Use the Insurance tab to manage the clients' insurance polices, authorizations, and verifications.
Ins 1.png


  • By default, all clients have the Self Pay Policy.
  • If the client doesn't have any insurance, you will need to edit this policy and change its priority from self to first.
  • View Optum Registration Form will show all the information required for Optum and list any missing information.
  • If you need to view expired insurance policies, they can be found under View Old Insurance Policies.
  • Form more information about Unit Counters see Unit Counters.

Add Policies

  • Click the green Add New Policy button to display the New Insurance Policy dialog.
Ins 2.png


  • Policy Owner: this list is populated from the client's relationships.
    • If the policy belongs to someone besides the client (e.g., a parent), choose the appropriate person here.
  • Payor: choose the insurance company. For more information see Payors
  • Plan: choose the specific plan, if you need to add a plan that is not already in the system, click Ins 3.png. For more information about plans see Payor Plans
  • Group #: enter Group # if applicable.
  • Policy #: enter Policy # if applicable.
  • Priority: EMR-Bear will try to bill the insurance based on the priority.
  • Deductible: any deductible amount require for the policy.
  • Copay: any Copay required for the policy.
  • Notes: optional note field.
  • Valid Since: when this policy becomes active.
  • Medicaid ID: enter medicaid ID if applicable.
  • Medicaid Name: enter the name that Medicaid has on file for the client, if it differs from the client name in EMR-Bear.
  • OHNM ID: Optum Health New Mexico ID
  • Reference #: reference number.
  • Insurance Card Image: optional upload of a scanned insurance card.
  • Insurance Card Comment: comment for the uploaded insurance card.

Editing a Policy

  • To edit an insurance policy (e.g., to change the priority of a policy or fix a typo), click the pencil icon next to the name of the policy.
  • The Editing Insurance Policy dialog will appear.
  • Most of the same fields are available here as in the new policy dialog. However, you cannot change the Payor.
Ins 5.png

Removing a Policy

  • To deactivate or remove an old policy, click the Red button to the left of the policy you wish to remove

Adding a Verification

  • To add a verification for a policy, click the green plus sign next to Verifications.
Ins 6.png


  • The New Verification dialog will be presented.
Ins 7.png

Prior Authorization

  • To Add a Prior Authorization, click the Prior Auths button:
Ins 8.png


The New Prior Authorization dialog will appear.

Ins 9.png


  • Any Fee: check if the authorization is valid for any fee.
  • Fee List: enter the specific fees this authorization is valid for.
  • Provider: choose the specific provider this authorization is valid for, if applicable.