Update Patient Insurance Policies in Partner

You can quickly review and update patient insurance policies in either PCC EHR or in the Partner practice management system.


For information on how to review, add, expire, and make other policy changes in PCC EHR, read Update Patient Insurance Policies.

Watch a Video: You can also watch a short video that teaches you how to update insurance policy information for a patient: Review and Update Patient Policies. After watching that video, you can learn more about insurance policies by watching the Update Patient Insurance Policies: Billing Office video.

Read below to learn how to update policies in the Partner Practice Management System.

Review Patient Insurance Policies in Partner

Open the Insurance Policies screen (policy) to review and edit a patient’s insurance policies.

To quickly open the policy screen, run the Patient Editor (notjane), find a patient, and then press F2Edit Policies.

Other Ways to See the Policy List: Many Partner programs have direct links to the Insurance Policies screen. For example, if you are at the first checkin screen in Partner, press F1Check Inscos or Page Down to review insurance policies for the patient. The Charge Posting (checkout) program and the Patient Editor (notjane) also have links to the policy screen.

Policies are listed briefly at the top of the screen, and the details for the selected policy are shown at the bottom:

How to Read and Interpret the Policy List

  • Press the up and down arrow keys to select any policy. Once you have selected a policy, full details will appear in the box at the bottom of the screen. If the list of policies is too long to fit on the screen, press F3Scroll Forward or F2Scroll Backward to review the entire list. Press the right arrow key to view additional plan notes for the selected policy.
  • If any subscriber details are blank, such as the name or address, Partner will generate claims using the information from the guarantor account. If the policy holder’s address is the same as the guarantor’s address, you do not need to re-enter the address on the patient’s policy screen.
  • Unless it is expired, the first policy on the list is the patient’s primary insurance. Policies are auto-sorted: expired policies are automatically moved below active policies, and Medicaid policies appear below active non-medicaid policies. You can arrange your active policies to set the primary and secondary insurances by selecting a plan and pressing F6Move Policy.

Double-Coverage With a Single Insurance Plan

When a patient has two active policies with the same insurance plan (with one as secondary), Partner can send primary and secondary claims with appropriate insurance information.

Your practice can create separate policy entries for each covered person, such as each parent.

Update Patient Policies in Partner

You can edit, add, move, delete, or expire an insurance policy with a few, quick keystrokes. While inserting a new policy, you also have the options to copy a recently edited policy or automatically add the new plan to the record of any siblings or family members. When expiring a policy, you will have the opportunity to expire the same plan for all patients in the same family.

The function keys for each task are self-explanatory:

Select a policy on the screen using the arrow keys, press the appropriate function key, and follow the prompts on the screen. The more detailed instructions in the sections below will guide you through each task.

Important: You should never delete an old, expired policy. There may be account history and/or outstanding balances pending a policy, or you may later need to know previous plan information for a patient. Instead, insert a new policy at the top of the list and expire the old policy.

Add an Insurance Policy to a Patient’s Record

When a patient’s insurance information changes, you need to add a new plan to their list of policies. You should do this before posting charges for the patient. Otherwise, the procedures may be billed to the wrong carrier or with the wrong information.

Follow this procedure to add a policy:

Open the Patient’s “Insurance Policies” Screen

You can view a patient’s insurance policies on the second page of checkin, from the Policy key in the Patient Editor (notjane), or many other ways.

Press

F1 – Insert Policy


A new line will appear at the top of the list of insurance policies, and blank fields will appear at the bottom of the screen.

Optional: Copy Details From an Existing Patient Insurance Policy

This family’s most recently edited policy is shown in the middle of the screen. Press

F5 – Use Last Modified

to copy that policy’s details into the new policy fields at the bottom of the screen.


The blank fields will be filled out with all available information from the most recently edited policy.

Enter (or Update) Policy Details

Enter policy information in the blank fields. If you are copying the last modified plan, update information that has changed, such as the certificate number.

Keep In Mind:

  • Look Up the Insurance Company: For the Insurance Company field, you can use an asterisk (*) to search through your practice’s list of plans. For example, entering *BCBS* would show you a list of BCBS insurance plans. Depending on how your office tracks insurance companies, typing *4624* may show you all insurances with a P.O. Box of 4624, a handy shortcut.

  • Override Fields: When generating claims, Partner will use the guarantor’s name, address, and relationship as recorded in the fame and notjane programs. If the insurance policy holder is not the guarantor, you should fill out the name, relationship, and address fields shown above.

  • Effective Dates: The effective dates are very important. Partner chooses which insurance company to bill based on the effective dates. You can leave the date fields blank, but Partner will then assume that the insurance plan has always been valid and that the coverage has no known expiration.

Press

F1 – Save

As soon as you press F1, the new policy will be saved and active for this patient.

Optional: Copy the New Policy to Related Patients

If the new policy is not a Medicaid policy, and the patient has siblings that share the same guarantor, Partner will next ask whether you wish to add the new policy to the patient’s siblings. A sibling is any patient who shares a guarantor with the current patient.

Press F1Copy Policy to continue to the sibling screen, press F4Do Not Copy or F12 to continue without modifying siblings.

On the sibling selection screen, confirm the position (primary, secondary, etc.) of the new plan and update any differences to the certificate and group numbers for each patient.

Press F1Save to add the plans to the sibling records.

If you do not wish to copy the new policy to any of these patients, press F12.

Review Your Changes

Finally, you will be returned to the main policy screen. After adding a new policy, you should review all active insurance policies for the patient. Is the primary insurance listed first? Do you need to expire an old policy? Use the function keys at the bottom of the screen to make any further changes to the patient policy record.

Edit an Existing Insurance Policy on the Patient’s Record

You may discover a bad certificate number, or learn that a policy is in a different parent’s name and not that of the guarantor account. Follow this procedure to change information about an insurance policy that is already on an account:

Open the Patient’s “Insurance Policies” Screen

Select a Policy

Use the arrow keys to select the insurance policy you need to edit.

Press

F4 – Edit Policy

The screen will change to allow editing, and your cursor will move to the “Insurance Company” name field.

Make Changes

Use the Tab, Enter or arrow keys to move to the field that needs to be changed.

Save Your Changes

When you are finished, press F1Save to save your changes. If you make a mistake or choose not to save your changes, press F12.

Important: You should never overwrite an existing policy with a new plan, even if only the address or the copay has changed. There may be outstanding charges pending the old policy or you may need to reference the family’s insurance history. Instead, use F5Insert Policy. You can then press F5Use Last Modified to grab the information from the previous policy. When you finish adding the new plan, use F8Expire Policy to expire the changed policy.

Expire a Patient Insurance Policy

When you add a new insurance policy to a patient, you will usually expire an old policy. When you expire an insurance policy, you will also be given the option to expire the same policy for all patients with the same guarantor.

When you wish to expire a policy, follow this procedure:

Open the Patient’s “Insurance Policies” Screen

Select the Policy You Want to Expire and Press F6 – Expire Policy


Enter the End Date

Yesterday’s date will be entered automatically in the “End Date” field for the policy. You can enter a different date, indicating when the policy expires. The end date is the last date on which the selected policy should be billed for new charges.

Press F1 – Save

Press F1 to save the policy’s end date and expire the policy.

Optional: Expire Policy for Patient Siblings

Next, Partner will ask if you wish to expire the same policy for the patient’s siblings. A sibling is any patient who shares a guarantor with the current patient.

Press F1Expire Policy to continue to the sibling screen, press F4Do Not Expire or F12 to continue without modifying siblings.

On the Expire Policy for Related Patients screen, review the policies for each of the siblings and press F1Expire Policies to continue. You can change which policies will be expired by deselecting them or using the selection function keys at the bottom of the screen. Press F12 to cancel and leave the siblings’ policies untouched.

Toggle Detail: If you need more information about the listed policies, press F5Toggle Detail.

You can only expire policies that match the one you just expired. You will not be able to select and expire a sibling’s policy unless it uses the same entry in the Insurance Companies table in the Table Editor (ted).

Press F1 – Expire Policies to Expire Selected Policies

Make a Policy Primary, Secondary, Teriary

When you post charges, Partner pends them to the active insurance policy on the patient’s account. But what if the account has more than one active policy? Which policy is the account’s primary insurance? Partner will send the charges to the first policy, and after you post payments and adjustments Partner will optionally bill the next responsible party. Therefore, you may need to adjust the order of a patient’s active policies. Follow the procedure below.

Open the Patient’s “Insurance Policies” Screen

Select a Policy

Select the policy you wish to move. Use the up and down arrow keys to move to the policy.

Press F6 – Move Policy

Press F6Move Policy. You will see the “Move Policy” message.

Move the Policy

Use the arrow keys to move the policy where you want it. The screen will update as you move it, showing you the result of the move.

Press F1

When you are finished, press F1Save to save your changes. If you make a mistake or choose not to save your changes, press F12.

Delete an Insurance Policy From a Patient’s Record

Under rare circumstances, you may need to delete a policy from a patient’s record. You should not delete expired policies under any circumstances. If any charges have been posted while a policy is active, you should not delete that policy, even if the charges were posted in error.

If you have added the wrong plan to the wrong patient, however, or the account never had a certain policy, you can do the following to remove it from the patient’s record:

Open the Patient’s “Insurance Policies” Screen

Select the Policy

Use the up and down arrow keys to select the inaccurate policy.

Press F4 – Edit Policy

Press F7 – Delete Policy

You will see a warning screen, prompting you to confirm deletion.

Press F8 – Delete

If you are certain you want to delete the selected policy, press F8. If you change your mind and wish to keep the selected policy, press F12. Once deleted, there is no way to “undelete” a policy.

  • Last modified: August 29, 2018