How to Add and Update Patient Insurance
Important Guideline: You should never update an existing insurance record. You should always TERMINATE an existing insurance record and then create a new one. Just changing the dates in an existing insurance record creates eligibility problems in the reports.
In this guide, we will show you how to properly add and update a patient’s insurance in eCW.
First, click the patient lookup button and search for your patient.
Once you find the patient you are looking for, click a blank area in the patient’s row to highlight the patient. Once highlighted, click “Patient Demographics” in the bottom lefthand corner.
Alternatively, you can click the patient’s name to open up the patient hub. From here, click “info” to view the patient demographics.
How to Add a New Insurance
Important note: If you are adding a primary insurance and the patient already has a primary insurance, make sure to terminate the prior insurance before adding a new one. NEVER change the coverage dates of an old insurance to match the new one. ALWAYS create a new insurance with the new dates.
First, we will go over how to add a new insurance to a patient’s profile.
At the bottom of the patient demographic window, select the blue tab for insurances, then select add.
In this window, you will be able to add/update the patient's insurance.
If this is a new insurance for the patient, type in the “name” box to search for the insurance. You can filter results by clicking the three dots to the right.
Once the insurance has been found, the box under the insurance name should populate the insurance information. Now, proceed to add additional information for the insurance.
First, choose whether this insurance is the patient’s primary, secondary, etc.
Next, choose the source of payment, class of reports, and insurance coverage dates.
Important note: When adding coverages dates ALWAYS make sure to use the calendar button to the left of the box to add the date. Do Not type the date in.
Next, add the subscriber number and the Insured’s Name.
Finally, add the Co-pay and patient relationship.
When adding a Co-pay, do so by adding the dollar amount in the “Co-pay box”. If there are multiple Co-Pays for different encounters, make sure to add them all by clicking the “Multiple Co-Pay” box
If you have completed the insurance correctly, all the sections in the image below should have been added or updated:
Afterward, you may continue to add additional insurance information.
Once finished, click “ok” to add the insurance.
Important note: Only the primary care clinic needs to enter MCares insurance (you do not need to re-enter insurance when patients are referred for specialty care). Coverage dates should NEVER exceed one year.
The insurance should now appear in the patient’s insurance list in the patient demographics.
Patient Insurance Details
From the insurance section of the demographics window, you can see information about all of the patient’s insurances.
The double arrows to the left allow you to move an insurance up or down in the list. To move an insurance, click and drag the box under the double arrows next to the insurance you would like to move and move it to the preferred area.
The third box from the left tells you whether this insurance is primary, secondary, etc. For example, “P” means primary.
Lastly, you can tell which insurances are currently active by looking at the letters associated with the insurance. If the letters are black, the insurance is still active. If the letters are grey, this is no longer an active insurance.
Sliding Fee Schedule
From the insurance section, you can also add and update the patient's sliding fee schedule.
Click “Sliding Fee Schedule” to open the window
In this window you can add the information necessary to accurately access the patient's sliding fee schedule.
If this patient does not have proof of income, select the box at the top left to indicate this:
Continue on to add the Guarantor and Spouse income information. Enter the Hourly amount for hourly work and the bi-biweekly amount for salary work.
If the patient has other forms of income, click the box to the name of the source of income. If the patient has an income not listed, type the name of the income in the box next to “other income”.
Once all incomes are selected, add the amount generated monthly by each income in the boxes to the right of “Monthly Amt”.
Once all of the additional income is added, the total gross amount and total gross income should automatically be calculated.
Under the “Income Status” section, choose the rate at which this income is received and add the number of family members this income supports.
To add the Documentation on Proof of Income, click the “Documentation on Proof of Income” box and select the documents by clicking the box next to their names.
Once all fields are complete, click “Calculate” to calculate the sliding fee schedule. The sliding fee schedule should now be calculated on the right side of the window under “Assigned Sliding Fee Schedule”.
The box underneath should show a list of household members. You can add additional members by clicking “add” and searching by your preferred criteria.
You can also add additional notes under the “Notes” section.
If everything looks good, click “assign” at the bottom of the window to assign the schedule.
If you ever need to edit the Sliding fee schedule, open the window again, edit the information, and click calculate to calculate the new schedule. You can view the history of the schedule by clicking “history” at the bottom right of the window