Adding Insurance Information

From DuxWare Manual

To Add Insurance Information

Choosing or adding the correct Insurance Policy

The Patient’s “Insurance Policy” information may be added after the demographics have been entered.
To add a plan and policy, choose Add a new Policy on the “Insurance Policy” bar at the bottom of the Patient Information Screen.

Insurance Policy Information:
You can enter the Insurance Policy Information at the bottom of the Patient Information screen.

Select Add a new Policy:
The first Insurance you put in will be the Primary - the drop-down defaults to Primary. Add Policy Number - Required Field - to Add a new Policy you must have a policy number – you cannot Add a new Policy without a Policy Number. Add Group Number - if you have it – if not leave blank.

Enter Effective Date:
If available, enter the effective date of the policy. You will not know Expiration Date unless there is a Policy that is no longer in use and you will be Deprecating it leave it blank.

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First choose the “Filing Order” of this Insurance for the Patient. The “Filing Order” will be the default order in which Claims will be filed to all of the Insurances listed for this Patient.

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During the claim creation process, the defaults will file the claims to the insurances in order of their “Filing Order”. The order may be changed at the claim creation time if necessary. Enter the appropriate search criteria to link the Patient to an existing Insurance payer or add a new one.

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The “Policy Holder” is the person who is listed on the Insurance card for this Patient. DuxWare will default to "Self" as the Policy Holder. If the patient is not the Policy Holder, you can edit by selecting [Change]. Then select [Add New] and fill in the blanks. You can also select search if you believe that the Policy Holder is also listed as a Patient or Guarantor. If the person you are looking for appears in the list, select them, and they will become “Policy Holder” for the Insurance you are entering for this Patient. If they do not appear in the list they may be added by selecting “Add New” at the top. Repeat this step for each valid Insurance for the Patient. To edit an existing policy for a Patient simply select the “View or Edit Policy Information” bar at the bottom of the Patient Information Screen.

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In the Other Information box Insurance Type Code is only used if the Secondary Insurance is Medicare. Choose from the drop-down to answer why Medicare is Secondary. Medicare will not pay unless this information is given.

Deleted yes or no is used if you are deleting this insurance because it was added in error.
If this insurance has claims entered against it, use Deprecated not Deleted.

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Copay/Deductible:
The “Standard Co-Pay” entered at the bottom of the screen will appear both on the Patient Information Screen and on the Patient’s “Superbill”.

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Images:
The front and the back of the Insurance Card can be scanned and placed here. Save the images as .jpeg files and remember where you saved them.
You can then browse for the files and place them here.

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Now, you can see the Insurance Information on the Patient Information screen.

If the patient has a Secondary Insurance Policy, just "Add" a new Policy, and follow the same steps that you took to Add the Primary Policy.
This time, because you are entering a second insurance, it is going to come up as Secondary.

Click on Select Carrier – the Payer Search window will come up.
Type in the Insurance Company, and choose Search.
Choose the Insurance from the list.
Select the Policy Holder.
Scan the Insurance Card and upload the images – enter the

  • Co-pay and the
  • Deductible

Choose Save.

Now you have your Primary and Secondary, and of course, you would continue to Add New if the patient had more than two insurance policies.

If the Insurance Company has changed since the Patient's last visit, and they have new policies, you should follow these steps:

  • Click on the one you want to edit.
  • If this Insurance is no longer good, select Deprecated in the Filing Order drop-down and put in the Expiration Date.
  • Choose Save. (You can see it is now removed from your list.)

And, if you need to Add a New Policy, just choose Add a New Policy.
The drop-down will default to Tertiary since this is the third Insurance you are entering for this Patient.
Choose Primary if you are replacing the Primary Insurance (Secondary if you are replacing the Secondary).
Type in the information and save the new Insurance.

If you Deprecated an Insurance, and you did not mean to, you can go back in and change it back. It now appears back in your list.

Any Claims you have billed against that Insurance Company will stay attached to that Insurance.

Even though you have Deprecated the Insurance Policy, the Claim always stays attached to the Insurance.

If you have a patient who has no Insurance,the Insurance Box will say, "No Policies for this patient."

Batch Check Eligibility is explained in another section of the manual.