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    WebPT EMR | Add or Edit Patient Insurance
    • 21 Mar 2024
    • 4 Minutes to read
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    WebPT EMR | Add or Edit Patient Insurance

    • Updated on 21 Mar 2024
    • 4 Minutes to read
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    Article Summary

    Overview

    You'll need to add Patient Insurance plans to the patient chart and the patient case, unless the patient is Self-Pay (or cash-based). Review the steps below for the general layout and process of adding insurance to a patient’s chart. Individual insurance windows may vary when adding insurance to a patient’s chart depending on the insurance type chosen (i.e., Medicare, PPO, etc.).

     
    Click the arrow or colorblock below to discover more about each Patient Insurance field.

    Add a New Insurance

    WebPT EMR | Add a New Insurance

     

    1. Go to the patient's chart and select Patient Info.
      EMR_Patient Chart Menu_Patient Info

    2. Click the Add Insurance link.
      EMR_Patient Manager_Patient Info_Add Insurance tab

    3. Type the insurance name in the Insurance name field select the patient's insurance plan (payer) from the list using the radio buttons. For Self Pay patients select the pre-built selection of Self-Pay for cash-based patients. Insurance plans may be listed in a variety of ways, ensure you have searched using several search terms before adding a new insurance plan. Discover how to add a patient's insurance plan if it is not in the list.
      EMR_Patient Manager_Info_Add Patient Insurance_New Insurance_Insurance List

    4. Click Next.

    5. Fill in the Policy Information including the required Subscriber ID/MBI. Click Next.
      EMR_Patient Manager_Info_Insurance_Policy Info_Overview

    Billing Integrated Members

    If you are integrated with a billing application, the following fields have character limits:

    • Group = 15 characters
    • Subscriber ID/MBI = 20 characters
    Edit Patient Insurance

    WebPT EMR | Edit Patient Insurance

    1. Go to the patient's chart and select Patient Info.
      EMR_Patient Chart Menu_Patient Info

    2. Click Edit for the Insurance you need to change.
      EMR_Patient Manager_Patient Info_Edit Insurance_Medicare

    3. Verify the Insurance selected is the one you want to change.
      EMR_Patient Manager_Patient Info_Edit Insurance_Next

    4. Make your changes to the Policy Information or Guarantor Information details and click OK.
      EMR_Patient Manager_Info_Insurance_Policy Info_Overview

      EMR_Patient Manager_Insurance_Guarantor Information

    5. Click Save Patient.
      EMR_Patient Manager_Patient Info_Save Patient

    Visit Reset Date

    WebPT EMR | Update, Restart, or Adjust the Visit Count

    Use the Visit Reset feature to update the number of visits allowed by the patient's policy, restart the visit count, or to adjust when the visit count starts for the patient.
    Discover more about How to Set and Reset Visits.

    Copay/Coinsurance

    Enter the Copay/Coinsurance information to prompt for payments during the patient appointment check in process.

    Discover more about Copay payments.

    Deductible

    Check the Deductible Met checkbox, if the Deductible has been Met. This is not auto-calculated.

    Insured Party

    The Insured Party should list the policyholder, not the individual responsible for paying any outstanding patient balance. This defaults to Self for everyone over 18. If you change the insured party to something other than Self, the system prompts you to enter the insured party details.

    Summary of Financial Responsibility

    The Summary of Financial Responisibility provides an option to note additional insurance and financial summary details for the patient's insurance benefits (i.e. Deductible remaining or Copay). This information also appears on the printed Patient Demographics attestation.

    Prior Existing Treatment

    For Medicare insurance types, type the amount of the Prior Existing Treatment. You may enter the dollar amount of treatment the patient has received for OT and PT/SLP, respectively. This information is used to alert you when you might need to use the KX modifier. Click Next to continue. Discover more about the KX Modifier.

    EMR_Insurance_Medicare Prior Existing Treatment

    Guarantor Information

    WebPT EMR | Guarantor Information

    If the person financially responsible for payments is someone other than the patient, Add the Guarantor Information then click Ok to save the Insurance. The Guarantor must be at least 18 years old. Discover more about Guarantor Information.

    AdvancedMD Intgrated Members

    If the Insured Party or Guarantor is another patient—or listed as the Insured Party or Guarantor on another patient—the information entered on each patient chart must match exactly to avoid any Claims Feed Report errors. Keep in mind this information is case-sensitive (i.e., lowercase and capital letters).

    For example, if you enter the First Name, Last Name, Date of Birth, and SSN for the Guarantor, then you must enter the same information (First Name, Last Name, Date of Birth, and SSN) when they are listed as the Guarantor on any other patient.

    EMR_Patient Manager_Insurance_Guarantor Information

    Add the Insurance to a Case

    WebPT EMR | Add the Insurance to a Case

    After adding new insurance, you will need to apply the insurance to a specific case.
     

    1. Go to the patient case and click the Edit icon to add the insurance to a patient case.
      EMR_Patient Manager_Patient Info_Case tab_Add Case or Edit Case

    2. Use the Primary Insurance drop-down menu to select the insurance and click Ok.
      EMR_Patient Manager_Patient Info_Case_Primary Insurance dropdown

    3. Click Save Patient. The insurance will now appear in the patient's case.
      EMR_Patient Manager_Patient Info_Save Patient

    Add Worker's Compensation Insurances

    WebPT EMR | Adding Worker's Compensation Patient Insurance Type

    Worker's Compensation Insurances have several required fields in the WebPT EMR.

     
    If you are integrated with WebPT Billing, the Employer's Name is also required. Additionally, you must enter the patient’s Social Security Number in the Subscriber ID field.

    EMR_Patient Manager_Patient Info_Case_Workers Comp Insurance Type

     

    EMR_Patient Manager_Patient Info_Case tab_Add Case or Edit Case

    Add Auto/PIP Insurances

    WebPT EMR | Adding Auto/PIP Patient Insurance Type

    The Auto Claim or Casualty Number is a required field.
     

    EMR_Patient Manager_Patient Info_Case_Auto PIP Insurance Type

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