Add or Edit an Insurance Plan

You would typically add a patient's primary or secondary insurance plan when you create the patient record. However, you can add or edit plans any time.

1. On the Patient Overview window, click the Primary or Secondary link in the Dental Insurance section.
   

   The Add/Edit Dental Plan window is displayed.
   
   

2. If the patient's insurance coverage is not entered in the system but coverage does exist for a family member on the same account, the system will display a list of plans on the Account Insurance Plans window. If the patient is covered under one of the displayed plans, select the plan and then click Select. The Account Insurance Plans window closes, and the Add/Edit Insurance window will be populated with information from the selected plan. If the patient is not covered by one of the listed account plans, click Close.

   Tip: Click the insurance plan ID to view details about a plan. If necessary, you can filter the list of account plans by entering text in the search field and clicking Search Plans or also by clicking Select filter and choosing a filter from the list. Click View to view the insurance plan associated with the family members linked with this account. It is also possible to delete a plan from this window by clicking Del in the appropriate row; however, this is not recommended.

   
   

   Note: You can also enter the Effective and Cancel dates for the insurance plans displayed here.

3. If desired, click in the Subscriber Insurance Card field and scan the patient's insurance card into the system. You can then click the thumbnail image to view the card as you enter details about the patient's insurance. For more information see Scan a Patient's Insurance Card.
4. If you did not select an insurance plan for the patient in step 2, you can search for the appropriate plan in the system. To do so, take the following steps:
   1. In the Group No. field of the Subscriber Information section of the Add/Edit Dental Plan window, enter an insurance plan ID, carrier name, employer name or group number and then hit the Enter key or click the magnifying glass.
      
      The system displays a list of plans that meet your criteria.

      

   2. Select the correct plan from the list and click Select. To view additional details about a plan, click its insurance plan ID. You can then select the plan by clicking Use in the Additional Details window. (If necessary, you can further narrow the list by entering search text and clicking Search Plans.)

      The Add/Edit Insurance Plan window redisplays with the Plan Information and Carrier/Employer sections populated with information from the selected plan.

      Note: If the desired plan is not shown, it must be added to the practice database by an administrator.

5. Select the appropriate subscriber from the Member Subscriber list. The other fields in the Member Subscriber section will populate based on your selection. If you select Other, you will have to enter or edit some of the the following fields manually:
   • Subscriber's name
   • Address - Note that this field is autopopulated with that of the responsible party.
   • Phone number
   • Subscriber ID
   • Birth date
   • Sex
6. Enter a date in the Effective Date field when you add a new insurance coverage. If the date is not known, select Unknown in the date field as shown in the following image.
   
7. When you select Unknown in the Effective Date field, the Dental Insurance section in Patient Overview window displays Unknown in red indicating that this field must be updated.
   
8. Complete and confirm the plan information.
   Following are some tips:
   • Required fields are indicated by a red asterisk.
   • You must specify a value in the Patient Rel to Sub (patient relationship to subscriber) field to activate the coverage for the patient. If it is set to None, coverage will be deactivated (but not deleted).
   • To indicate that you have verified the patient's insurance, click Insert Date Stamp next to the Patient Last Verified Date field. For more information about verifying eligibility, see About Eligibility Verification.
   • In the Family Coverage section, if necessary, you can update the coverage for other family members in the Coverage column and their relationship to the subscriber in the RelToSub column.
9. Click Save.