Add and Configure Insurance Plans to Your System

When your practice updates a patient's insurance policies, your PCC server logs what was done, when it was done, and by whom. You can use the under-the-hood Policy Log (policylog) tool to review a log of all changes ever made to a patient's insurance policies.

If your office has created duplicate patients or family accounts, you may need to merge them. Merging two patients combines data and saves a single set of basic demographic information. Merging two accounts combines the account billing and charge data so that it appears all of it occurred under one account.

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 in this article to add a new plan to your PCC system.

This article is a reference to the Insurance Companies table and the Insurance Groups table used in PCC software. You can edit both tables in the Table Editor (ted), found in the Practice Management interface in PCC EHR. Insurance tables contain information about the insurance plans on your PCC system, which are used for billing and reporting.

The hedfe program is a HCFA/CMS 1500 form editor. It can configure both the layout and the content of claim forms. You can use the program to move form data around or change how it is filled out. Simple errors on claim forms can delay payment and cost your practice both time and money. Therefore it is important to understand how Partner fills out HCFA forms and how to make changes to your forms when necessary.

PCC can track your contract fee schedules, also known as "allowables", in the Contract Fee Schedule Editor (allowedit). You can create and manage multiple contract rates, make changes to expected fees that will occur after a specific date, and assign the completed contract fee schedules to specific insurance plans. The Post Insurance Payments (pip) program will then display the contracted fee or “Allowed” amount when posting payments for charges pending those insurance plans.

Contents1 Create the Insurance Groups, Plans, Fees, Payment Types, and Accounts to Record and Track Payments2 Post Capitation Payments Capitation payments are not like other income. How should you configure the PCC billing system so you can enter and track capitation payments over time? Read the steps below to learn how to create appropriate insurance […]