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Recommend  Print General Section: Insurance Tab

Recommend Print General Section: Insurance Tab

All relevant insurance information should be entered under this tab. 

 

Note:  It is especially important that all insurance information be entered into these fields correctly from the client's insurance card.  This will reduce the chance for billing denials or other payment issues.

 

To make edits to existing insurance information, click to highlight the line to be edited in the list view.  This will populate fields that can be edited .  Click on theUpdate button to update the information or click on Cancel to cancel the edits.  Note:  Update=Enter; Cancel=Escape.

 

 

Click on +Add and start by choosing the appropriate Source from the drop-down (this is the insurance carrier that funds the client).  Note:  these are pre-configured within OTBO.  

 

 

Id is the funding source id.  This is the insurance number associated with the client's funding source (ex. If the funding source is Medicaid, this is where the Medicaid id # is entered).  Fields for Group Number and Dates of Eligibility are also available.

 

Funding Agent is typically the payer for the client’s services.  Accuracy is important as this is how the system will know who to send the billing claim to.  If the correct funding payer is not an option, again, contact the  company's system administrator.

 

Enter the Primary Care Physician if the client’s funding source requires the PCP’s NPI on the claim.  An example of this is the Carolina Access funding stream.  It is best practice that when a PCP is listed on the insurance card that it gets entered into the system.  The list of PCP’s is maintained in the Configure desktop under the List Configuration screen.

 

Insured DOB and Insured Sex are important, particularly if the client is carried on someone else’s policy.  In that event,  the insured’s info should be entered here if the client is not insured on his or her own.  Inactive can be toggled on/off if insurance has expired.  Click +Add to add a whole new insurance source and then simply inactivate the expired record.

 

By clicking on the DMS icon, a scanned copy of the insurance card can be uploaded to the client record.  A Delete icon is available to delete insurance information.  

 

 

Funding Source, Id, and Funding Agent are required in order to save the insurance information to the client record. Once this information is entered, saving to the client record is done by clicking on the update button.

 

It is recommended that all data fields be completed when entering client insurance information.