Step 3-Patient & Insurance

TABLE OF CONTENTS

• Patient
  • Example Views
• Insurance 
  • Example View
• Select "Next"
• Guide me to Step 4-Service & Diagnosis

In this step you will enter the patient demographics and insurance information of the patient.  

Patient

• Depending on the portal chosen, you will be asked to provide certain information pertaining to your patient. Each individual payer portal requests different information be provided, so this information may changed throughout different portals you submit through.
  • First and Last Name of the patient
  • Patient date of birth
  • Height & Weight
  • Gender
  • Patient Address
  • Patient Phone Number

Patient demographics will be entered in one of two ways:
--Entered Manually
--Pre-populated and selected.

If the patient you are looking for does not populate the patient will need to be entered manually.

Limitation
Edits cannot be made to an existing patients demographics.  You will need to enter the patient information in again with the correct information.

Example Views

Insurance 

• All of the below information should be found from the Member ID card.
  • Company
    • Select the Main Insurance Organization for the Member. (Example: Ambetter is a Marketplace, not a main insurance payer. Your Member ID card may say "Ambetter from Buckeye Health Plan". Your main payer would be "Buckeye Health Plan"). 
  • Member ID
    • Enter Member ID from the Member ID card.
  • Insurance Type
    • Select plan type from Member ID card.
      • Currently we have the following selections: Medicare, Medicaid, Commercial, Other. 
  • Issuing State 
    • Select the issuing state of the plan. (This may not always be the same state the patient resides in. Check the Member ID card for the correct state). 

Example View

Select "Next"

• Select 'Next" to move to the next step in the progress! 

Guide me to Step 4-Service & Diagnosis

We're here to guide you through your prior authorization quest!