Managing and Tracking Patient Insurance

Manage current, past, and future insurance coverage for your patients.

About Insurance Archiving

Beginning on 10/5/2022, ClinicTracker will maintain a historical record of patient insurance policies over time. In addition to the list of current insurance policies listed on the Demographics screen, you may access the Payor Management form which allows you to enter new policies and archive previous payors.

Note: If your implementation began prior to 10/5/2022, your ClinicTracker Instance is set to show only the patient's current insurance. If you would like to turn on this new feature, please open a support ticket, by clicking on the blue Support tab on the right side of this page. All implementations after 10/5/2022 will have this ability by default.

Benefits

Enter policy changes ahead of their effective date
Prepare for open enrollment changes
Ensure staff select valid insurance policies when recording events on the Scheduler
Ensure staff select valid insurance policies when recording appointments within Patient Contacts
Maintain a historical view of a patient's policies
Ensure claims are created for the payor responsible for the date of service
Eliminate denials due to mismatched dates
Easily identify gaps in coverage

Adding a New Insurance Policy for a New Patient

Go to ClinicTracker > Patients > Demographic > Insurance Tab
Enter the necessary details
Click the Save icon

Viewing a Patient's Active Insurance Policy Details

Go to ClinicTracker > Patients > Demographic > Insurance Tab
Navigate the Primary, Secondary, and Tertiary Detail tabs to view each active insurance policy

Adding a New Insurance Policy for an Existing Patient

Go to ClinicTracker > Patients > Demographic > Insurance Tab > Manage Insurers
Click New
Enter the necessary details
Click Save

Editing or Deleting a Patient's Insurance Policy Details

Go to ClinicTracker > Patients > Demographic > Insurance Tab > Manage Insurers.
At the bottom of the form, you will see a list of all current and former policies.
Using the Limit to Priority dropdown, you can view only primary, secondary, or tertiary insurance.
Double click the policy you wish to view or edit:
- To edit the policy details, make changes to the fields you'd like to change and click Save.
- To change the priority (primary, secondary, tertiary) of the policy, click Move/Swap and select the change you'd like to make.
- To delete the policy, click Delete.

Note: We recommend only deleting records that have been added in error. The deletion of a patient's former policies means that you will not benefit from having them archived.

Note: As you update patient insurance policy details, ClinicTracker will notify you of gaps or duplicate coverage.

Insurance Policy Fields

Insurance Policy Details Section

Priority (Options are: Primary, Secondary, or Tertiary)
Coverage Start Date
Coverage End Date
Company
Policy/Member ID Number
Group Number
Policy Holder
Insured's Employer
Individual Copay
Insured's DOB
Last Qualification (This differs from Coverage Start Date and Coverage End Date, as it refers to insurance eligibility)
Next Requalification (This differs from Coverage Start Date and Coverage End Date, as it refers to insurance eligibility)
Coverage Cap
Insurance Copay
Group Copay
Annual Deductible
Annual Deductible Met

Patient Relationship to Insured Section

Select the radio button that reflects the patient's relationship to insured
If you select Other or Spouse, you'll need to complete these fields for the insured:
- First Name
- Last Name
- Date of Birth
- Address
- City
- State
- Zip
- Phone
- Sex

Note: If the Name and Address fields are not completed, your claim may be rejected or denied.