How To Claim Insurance In PureEHR?
Add Insurance Information of the Patient
To add insurance details of the patient follow the below-given steps:
Open the patient by searching the patient from the search box.
Go to the Insurance tab from Primary Information as shown below
Click on the Primary tab as shown below.
If the subscriber is the patient then check the Subscriber is the Patient checkbox as shown below.
The user should not check the checkbox if the subscriber is not the patient. When the checkbox is unchecked, additional fields will be populated where the user has to enter the details of the patient who is not the insurance holder.
Choose the Patient relationship with the Subscriber from the below-shown dropdown.
Enter the Subscriber First Name, Subscriber Last Name, Subscriber Middle Name, Subscriber Last Name, Subscriber DOB, and Subscriber SSN as shown below.
Enter Subscriber Address, Subscriber Zipcode, Subscriber City, Subscriber State, Subscriber Phone, and Subscriber Gender as shown below.
Enter the Insurance Company and Healthcare Program as shown below. Insurance Payer ID will be generated automatically after selecting the insurance company name.
Enter Insurance Company ID Number, Insurance Company Address, Insurance Company Zip Code, Insurance Company City, and Insurance Company State.
Enter Insurance Group Name, Insurance Group Number/FECA Number, Insurance Plan Name, Insurance plan type, and Number of visits allowed per year as shown below.
Enter Insurance card front and Insurance card rear images as shown below.
Now click on the Save button as shown below.
Prerequisites to Claim the Insurance
To claim any insurance, the user has to set an appointment for the patient. Only after the appointment is scheduled, claims can be processed.
To view the article regarding creating a new appointment, click here
Submitting the Claims to the Clearinghouse
Click on the Appointments tab in the patient chart as shown below.
Look for the appointment for which the user wants to submit the claim. Now click on the edit appointment icon under the Actions column as shown below.
NOTE: Claim submission for the upcoming appointments is not accepted.
Now go to the Billing tab from the side menu.
Now change the Billing Status to Bill Insurance as shown below.
Select the Insurance type as shown below
Select the Payment Profile as Insurance as shown below.
Select the Claim Type as shown below.
Now click on the Save button.
A batch file will be created of the claims whose status is changed. At an interval of 24 hours, the batch file will be sent to the clearing house (i.e. Waystar).
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