Specify insurance information

  1. (If you have not done so already) Add a new incident, or open an existing incident, as described Add or edit an incident.

    By default, the Scene tab appears.

  2. At the bottom of the screen, touch Insurance.

    Fields appear for specifying the information about any insurance the patient has.

  3. Do any of the following that apply to the patient.

    ClosedAdd Medicare insurance

    • Under Medicare, enter data as described in Understand the interface and data entry in it.

      Field Information needed

      Medicare Payer

      The health care program that is submitting the medical bills for the patient to Medicare.

      Medicare ID #

      The number that uniquely identifies a health care provider and is used on billing forms submitted to Medicare.
    ClosedAdd Medicaid insurance

    • Under Medicaid, enter data as described in Understand the interface and data entry in it.

      Field Information needed

      Medicaid Payer

      The list of insurance companies working with Medicaid to submit the medical bills for the patient to Medicaid.

      Medicaid ID #

      The number that uniquely identifies a health care provider and is used on billing forms submitted to Medicaid.
    ClosedAdd private insurance

    • Under Private Insurance, enter data as described in Understand the interface and data entry in it.

      Field Information needed

      Insurance Name

      The name of the patient's insurance company.

      Subscriber ID

      The patient's identification number to the insurance company.

      Group Number

      The identification number or name of the patient's insurance group.

      Insured Name

      The last (family) name, first (given) name, and middle name (if any) of the person insured by the insurance company.

      Tip: If the patient is the person with the private insurance, touch Copy Patient to copy the patient's name, rather than entering it again.

      Insured SSN

      The Social Security Number (SSN) of the person insured by the insurance company.

      Insured DOB

      The date of birth (DOB) of the person insured by the insurance company.

      Tip: If the patient is the person with the private insurance, touch Copy Resp Party to copy the patient's date of birth, rather than entering it again.
    ClosedAdd other payer or self-pay information

    • Touch Other Payer or Self Pay.

      A dialog box of fields appears.

    • Enter data in the fields as described in Understand the interface and data entry in it.

      Field Information needed

      First Name

      The first (given) name of the person paying the medical bills for the patient.

      Last Name

      The last (family) name of the person paying the medical bills for the patient.

      Address

      The home mailing or street address of the person paying the medical bills for the patient.

      City

      The patient's home city, township, or residence.

      Note: If the patient lives in an unincorporated area, use the city found in the mailing address for the patient.

      State

      The home state, territory, or province, or District of Columbia where the person paying the medical bills for the patient resides.

      Zip

      The ZIP code of residence for the person paying the medical bills for the patient. This is the numerical code assigned by the U.S. Postal Service to all U.S. jurisdictions.

      Relationship

      The relationship of the patient to the primary insured person.

      Phone

      The home or other phone number of the person paying the medical bills for the patient.

      Next of Kin

      The last (family) name, first (given) name, and middle initial (if any) of the patient's closest relative or guardian.

      Next Kin's Phone

      The home or other phone number of the patient's closest relative or guardian.

      Employer

      The name of the patient's employer.

      Employer Phone

      The phone number of the patient's employer.

      Date of Birth

      The patient's date of birth.
  4. For Hospital Face Sheet, touch Yes or No to indicate whether or not to include a cover sheet for the health insurance documentation.

  5. (Optional) Touch Take Picture of ID Card, and then use the iPad's built-in camera feature to take a picture of the front and back of the patient's insurance ID card.

  6. Closed(If necessary) Add additional private insurance companies.

    Example: A patient may have both Medicaid, and accidental insurance through a different insurance company,

    1. Touch Add Another.

      In the lower right corner of the screen, the insurance information you have added is summarized in the list, and the fields on the screen clear so that you can specify information for another insurance company.

    2. Enter information in the fields as you did under Add private insurance.

    3. Repeat step 6 as many times as necessary.
  7. (Optional) Attach an Advanced Beneficiary Notice (ABN) form to the patient's insurance information, as described in Attach an Advanced Beneficiary Notice (ABN).
  8. (Optional) Attach a Physician's Certification Statement (PCS) form to the patient's insurance information. as described in Attach a Physician's Certification Statement (PCS) form.