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#25 – Adds new insurance plan

Add New Insurance

There are several circumstances when you will be called upon to update the insurance policy information for a patient.  This could be when the patient’s employer has switched insurance companies, the patient has a new job, it’s a patient with a new employer to our system or it’s a patient with a new insurance company to our system.

  1. The new insurance carrier is in our system and you have added this employer as “new plan”.  Now you need to make sure the benefits are for that current employer and not the old one.
  2. You will need to contact the insurance company to verify the yearly maximum, deductible and % of coverage for preventative/diagnostic; basic (restorative), extractions and major(perio, oral surgery, bridges and dentures).
  3. Once you have this information, you will need to update the family’s information:
  1. go to the family file screen
  2. double click on the Insurance Box
  3. click on the coverage table box
  4. modify the annual maximum benefit individual box (i.e. 500, 1000, 1500, etc)
  5. modify the deductible annual individual standard box (i.e. 25, 50, 100, etc.)
  6. Coverage Table. If the insurance company gave you the standard %s for coverage table (100% for preventative/diagnostic; 80% basic and 50% major – you do not have to change any thing on this table.  However, if the insurance company told you any differences, they  should be changed here:
    1. highlight the category
    2. highlight the % number
    3. type in the new % number
    4. click the change button

(this must be done for each category you want to modify)

  1. When complete click on OK button
  2. The system will ask if you are sure you want to modify – click on the OK button.
  3. Payment Table. Click on the Pmt Table Box.  This table will show you what dollar payment amounts have been received for the other insurance policy that you copied when you added as “new plan”.  These dollar figures are added to the system as we receive eob’s from the insurance company.  We do not want to carry over the payments from one employer’s policy to another so please delete them.
    1. click on the Delete All button
    2. click on the OK button

 

To get signed off on this section, you must enter the new insurance plan for 5 patients.

You also must make sure a system exists to enter new insurance information in a timely manner for patients.

_________________________ Office manager  _____________ Date