You can enter a patient's third-party information into his or her patient record.
Note: All required patient information (name, gender, birth date, and address) must be entered before you can attach a third party to a patient.
To attach a third party to a patient
Important:
To attach a third party to a non-subscriber if the subscriber is a patient of your practice, you must have a patient record created for and a third party attached to the subscriber before you attempt to attach a third party to patients of record who are on that subscriber's plan.
To attach a third party to a non-subscriber if the subscriber is not a patient of your practice, you must have a patient record (with a status of Non-Patient) created for and a third party attached to the subscriber before you attempt to attach a third party to patients of record who are on that subscriber's plan.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
On the Patient menu, under General, click (or tap) Overview.
The patient's Overview page opens.
How to get there
Use the Patient Search box to access a patient's record.
Notes:
If the last patient record you accessed since you last logged on is the correct patient's record, you do not need to re-enter the patient's name in the Patient Search box.
You can include inactive patients in the search results by setting the Include inactive patients switch to On.
On the Patient menu, under Third-Party, click (or tap) Third-Party.
The patient's Third-Party page opens.
Do one of the following:
On a patient's Overview page, in the Third-Party box, click (or tap) Add.
On a patient's Third-Party page, click (or tap) Add Third-Party.
The options for entering third-party information become available.
Specify the Subscriber.
Do one of the following:
If the patient is the subscriber for the plan that you are going to enter, leave his or her name in the Subscriber box.
(Skip step 3.)
If the patient is the subscriber, use the Plan Search box to search for and select a third-party plan.
Do one of the following:
Select a plan by third party, plan name, or group number:
Select Search by Third-Party/Plan.
In the Plan Search box, begin typing a third-party name, a plan name, or a group number. Continue typing as needed to narrow the results list. Then, select a plan.
Select a plan by patient:
Select Search by Patient.
In the Plan Search box, begin typing a patient name. Continue typing as needed to narrow the results list. Then, select the patient with the correct plan.
Add a new plan:
If there are no results for the search criteria that you enter in the Plan Search box, click (or tap) Add New Third-Party or Plan.
The Add New Third-Party or Plan dialogue box appears.
Do one of the following:
Select a third party from the list of third parties that have already been added to your practice database.
Add a third party to your organisation's database:
Click (or tap) Add Third-Party.
The options for adding a new third party become available.
In the Third-Party box, enter the name of the third party. The name must start with a number or letter, not a special character.
Set up the other options as needed:
Phone number - The third party's main contact phone number and extension (if applicable).
Fax number - A fax number for the third party.
Website - The third party's website address. Do not include "http://" or "https://" at the beginning of the website address.
Notes:
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You cannot change the Third-Party name after you click (or tap) Save.
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You must save the third party's information to make the Available Procedures button available, so you can specify which procedures are available for posting to the records of patients who are covered by this third party (when the "Third-Party procedures" procedure filter is selected during posting).
Click (or tap) Save.
The options for adding a plan become available.
Set up the following options:
Plan - The name of the third-party plan. The plan can have the same name as the third party.
Group # - The group plan number.
Address - The address where claims for the third-party plan are sent.
Phone - The third-party plan administrator's contact phone number and extension (if applicable).
Fax Number - The fax number of the third-party plan administrator.
Contact - The name of the third-party plan administrator.
Email - The third-party plan administrator's email address.
Benefit Renewal Month - The month that the third-party plan's benefits reset.
Type - The plan covers dental or medical procedures.
Note - A note that is specific to this third-party plan. You can enter text, such as information from the third party. Also, you can insert a date if needed. The note is accessible from all patient records that have this third-party plan attached.
Click (or tap) Save.
Set up the rest of the options as needed, such as the subscriber ID, relation to the subscriber, coverage type, and coverage period.
Set up the following options:
Subscriber ID # - The ID used to identify the subscriber of the third-party plan on claims that are submitted to the corresponding third party.
Release of Information - The subscriber authorizes the release of information to the practice.
Assignment of Benefits - The subscriber authorizes payments from the carrier to go directly to the provider. With this check box selected, the third party will send payments to your practice. With this check box clear, the third party will send payments to the subscriber.
Relation to Subscriber - For a subscriber, since he or she is the current patient, Self is selected automatically and cannot be changed. For a non-subscriber, select Spouse, Child, or Other.
Coverage Type - The coverage order of the plan (such as Primary or Secondary). The number of items that are available on the list depends on the number of plans that have already been set up for this patient. If there are no plans, only Primary is an option; if there is one plan, Primary and Secondary are options; if there are two plans, Primary, Secondary, and Tertiary are options; and so on.
Coverage Period - The date range that coverage under the plan is valid for the subscriber and his or her dependents. In the Coverage Start and Coverage End boxes, enter the date when coverage started and, if known, when it will end. For a non-subscriber, you can specify an end date that is before or the same as that of the subscriber.
Eligibility - The patient's eligibility for coverage under the plan has been checked. If known, select the patient's eligibility status from the list: Unable to Verify, Eligible, or Ineligible. Then, enter today's date (or the date that eligibility was actually checked) in the Verification Date box.
Note: Changing the eligibility status here affects the patient's eligibility status for his or her appointments on the Insurance Eligibility page and vice versa.
Note - Any notes regarding the third-party plan.
Click (or tap) Coverage Table to edit the coverage table for the third-party plan.
Click (or tap) Benefits to edit the deductibles and benefits for the third-party plan. Access to the deductibles and benefits is available only if a subscriber and a plan have been selected. When you attempt to access the deductibles and benefits, if you have not already saved the plan, a message appears and states that you must save the plan before you can access the deductibles and benefits. Click (or tap) Yes to save the plan and continue.
Click (or tap) Save.
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