Add an Insurance Plan to Your PCC System
When a patient or parent brings in a new insurance card, you can update their insurance policies quickly and easily.
However, what if the insurance plan is entirely new to your practice? Maybe it is an existing plan (like BCBS), but it has a new address, copay amount, or payer ID.
Follow the steps below to add a new plan to your PCC system. Insurance plans are maintained in the Table Editor (ted) in the Practice Management window in PCC EHR.
Watch a Video: You can learn more about insurance plans, and see an example of adding a new plan to your system, by watching Review and Update Patient Insurance Policies and Review Policies in Practice Management and Add an Insurance Plan to Your System.
Open the Practice Management Window
Use the Practice Management window to perform under-the-hood configuration and advanced billing operations in PCC EHR.
Run the Table Editor (ted)
Open the Table Editor in your Practice Management windows. The location of the program may differ in your practice’s windows.
If you have never run ted before, you should ask your practice’s office manager or system administrator or contact PCC Support.
Choose Table #3 “Insurance Companies”
Locate an Existing Insurance Plan Record to Copy
Find an insurance plan similar to the new one you are adding. For example, if you are adding a BCBS or Aetna plan, find a similar pre-existing entry to duplicate.
You can use the PAGE UP and PAGE DOWN keys to scroll through the list, or use the J key to jump to a certain number or name.
Press C to “Clone” the Existing Insurance Company
Press C, type the number of the company you wish to clone, and then pressEnter.
Why Not Add a New Entry, Instead of Cloning?: Insurance plans include billing configuration information, some of which is configured by PCC Support. If you clone an existing plan entry, you can be more certain that the plan will appear correctly and will be billed using your practice’s preferred configuration.
Enter Address, Payor ID, and Other Insurance Policy Information
Use the information on the back of the insurance card to make any changes to the plan name, address, or phone number.
If you have Payor ID information for electronic claim submission, enter it in the appropriate box. You may need to call the claims phone number on the card if the payer ID is not shown.
Change the Copay in the Name and in the "Default copayment" Field: If you are adding an insurance company with a different copay, make sure you change the copay amount listed in the “Insurance Plan Name” field and in the “Default copayment” field. The name is important so you can find the insurance company easily, but Partner will actually charge the amount that is in the “Default Copayment” field.
What About the Other Fields? Is There Anything Else You Should Worry About?
The Insurance Plan table has several fields used for billing purposes, sine of which may not be familiar to you. For example, the Insurance Group field affects some financial reports, the HCFA Batch field adjusts payer-specific claim requirements, and the “Special Information File” modifies coding, pricing and other per-procedure options for claims.
If you cloned a similar, existing insurance plan that your practice has billed, then most likely you do not need to adjust the other plan fields on this screen.
You can learn about all of the fields by reading the Insurance Tables Reference article.
PCC configures standard settings to meet all of these needs when your practice goes online, and we will help you make adjustments at any time to ensure that your claims go out clean and get paid. Contact PCC Support for assistance.
Press F1 – Save and Quit
Press F1 to create and save your new insurance plan. If you make a mistake or change your mind, press F12 instead.
Press F12 to Quit
While the above procedure works for most situations, you may encounter unusual payer requirements. PCC’s assistance is always just a quick e-mail or phone call away at <support@pcc.com> or 802-846-8177 or 800-722-7708.