Insurances

The Insurances section in EMR software allows healthcare providers to manage and store patient insurance details,
ensuring seamless billing, claims processing, and eligibility verification for accurate and timely reimbursements.

Graphic 1:

​Primary Insurance, Secondary Insurance, Tertiary Insurance, Auto Insurance,
​Other Insurance

Insurance Company Details This section stores the contact information of the insurance company for quick reference and communication:

• Company Name: Name of the insurance provider.
• Address: Insurance company’s physical address.
• Email: Contact email for inquiries.
• Phone: Customer service or claims phone number.
• Fax: Fax number, if applicable.
• Notes: Any additional important details related to the company.

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Primary Account Holder Details This section contains information about the primary insurance policyholder:

• Name: Full name of the account holder (First, Middle, Last).
• Insurer ID: The unique identification number for the insurer.
• Group: Group number, if applicable (e.g., employer-based coverage).
• Plan: The type of insurance plan (e.g., PPO, HMO).
• Policy #: The insurance policy number.
• Relationship: Relationship of the account holder to the patient (e.g., Self, Spouse).
• Notes: Any additional relevant information about the primary account holder.
• Effective Date: Date when the insurance coverage begins.
• Expiration Date: Date when the coverage ends.

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Payment Info This section captures details related to the patient's financial responsibility:

• Copay Amount: The fixed amount the patient pays at each visit.
• Copay Percentage: The percentage of the medical bill the patient is responsible for.
• Deductible Amount: The amount the patient must pay before the insurance coverage starts.
• Deductible Percentage: The percentage of costs the patient pays until the deductible is met.
• Deductible Met: Indicates whether the deductible has been fully paid.
• Prior Authorization #: A number related to any pre-authorization required for treatment.
• Notes: Any extra details about payment responsibilities or financial arrangements.