Payee Overview
Payee Overview
The information in the payee section of the Patient screen is a summary of the patient's primary and secondary insurance. The information in the screen includes information about the insurer, the patient (or insured), authorizations, deductibles and notes. You do not need to complete all of the information in the screen at one time. You can add the critical information and complete the rest later. The parts of the screen are as follows:
Insurer
Information about the primary and secondary insurer. Please ensure that the effective date is set prior to the DOS you are going to start billing from. the RefPhysician # field should be left blank.
Insured
Personal information about the insured. The information is automatically populated from the patient window, if not you can select Same as Patient and populate the information from the patients profile.
If the patient is a child, type the parent or guardian's name in the insured field, select Child from the Patient Rel drop-down box and type the parent or guardian's birth date in the DOB. This information is what populates the right hand side of the CMS1500 Claim Form.
Deductible
Contains the insurance deductible information including maximum out of pocket costs and any caps. This is for your reference and is not used in calculations.
Authorizations
Displays a summary of authorizations. Authorizations are limits by the insurance company on the number of visits or units.
EPSDT Codes and Family Plan
Allows the creation of rules for a discipline specific code to have an EPSDT Code associated and/or being defined as Family Plan.
Notes
These are notes for your office about insurance contacts and the best way to submit a claim.
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