|In This Section|
- Use the Insurance tab to manage the clients' insurance polices, authorizations, and verifications.
- 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.
- Click the green Add New Policy button to display the New Insurance Policy dialog.
- 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 . 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.
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.
- The New Verification dialog will be presented.
- To Add a Prior Authorization, click the Prior Auths button:
The New Prior Authorization dialog will appear.
- 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.