Page Description

Use the Insurance page to view, create, or edit patient insurance information, as well as access patient demographic and order information. You must first select a patient using the search feature before you can perform any of these tasks.

The Insurance Summary tab, which is selected by default, displays an overview for the currently selected insurance set for the patient. Copia will use the selected insurance set when evaluating medical necessity and determining billing for the patient's orders. You may establish multiple insurance sets for a patient, with each set containing up to three insurance plans: primary, secondary, and tertiary, and you may assign a guarantor to each insurance set.

If you attempt to change the primary insurance plan for an insurance set that has been used in an order, Copia creates a new insurance set for the patient with the current primary, secondary, tertiary, and guarantor information after you select a different insurance.

Depending on your system default settings, Copia may prevent you from creating patient insurance sets that contain non-validated insurance.

Note that you cannot add inactive insurance companies or plans to an insurance set. Also, if an insurance set contains an inactive insurance company or plan, Copia will not allow you to assign that insurance set to the patient until you have removed or activated the inactive insurance company or plan. This restriction also applies to patient insurance sets that use practice-specific insurance plans that are mapped to inactive system plans.

For more help, click one of the following links:

• Accessing this Page
• Navigating this Page
• Viewing or Selecting Patient Insurance Sets
• Adding or Modifying Insurance Plans
• Adding, Updating, or Deleting Photos
• Adding or Modifying Guarantor Information

Accessing this Page

• Click the Patient Info menu button, and then click the Insurance submenu link.
• Click the Insurance link below the Find Patient search field on the Demographics, Order History, Collect Samples, or Order Patient Samples pages. Note that if the Use pop-ups for patient Demographics and Insurance on Order Patient samples and Collect Samples pages option is enabled on the Application page or the Users administration page, then the Insurance page appears as a pop-up window from the Order Patient Samples or Collect Samples pages.
• Click the name of the desired patient, and then select Insurance in the pop-up list on the Find Patient or Order lab tasks page or the Lab Orders administration page.

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Navigating this Page

1. As with any program or web page displayed in an Internet browser, you may always use your mouse to click buttons or to make fields active (ready to accept input).
2. You may also press the [Tab] key on your keyboard to move through the available elements (fields or buttons) and change which element is currently active. Some users find this method faster than using a mouse. Copia allows administrators to set the tabbing order for this page (based on location or system default settings), so that the fields become active in the order most useful to the facility. When setting the tabbing order, administrators may also set one or more elements of the page so that Copia skips them when determining what field or button receives the cursor focus. Upon entering the page, Copia places the cursor at the first element not set to skip or the first unpopulated element if all the preceding elements are populated. See the Admin: Tabbing Order topic.
3. Even if a tabbing order is set, you may still use your mouse to access the desired page elements, including those skipped in the tabbing order.

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Viewing or Selecting Patient Insurance Sets

1. Use the Find Patient search feature to select the patient whose insurance information you wish to view. See the Selecting a Patient topic.
• If you selected a patient in another page before opening this one, then that patient's insurance is shown.
• If you did not find the correct patient in your search, you may need to create a new patient record. See the Demographics topic.
2. Copia displays the selected patient's name, age, sex, and Patient ID at the top of the Insurance page once the patient is selected. You may modify demographic and insurance information; review the patient's order history; or place an order, collect samples or create a blank requisition for the patient by clicking the links listed below.
• Demographics: Click this link (or press the [Alt] [U] hotkey) to view or modify the patient's demographic information. See the Demographics topic.
• Insurance: Click this link (or press the [Alt] [I] hotkey) to refresh the current page.
• Order History: Click this link (or press the [Alt] [O] hotkey) to view the patient's order history or edit an order. See the Order History topic.
• Options: Click this link to open a pop-up list of actions. Select the action you wish to take for the selected patient: New Order (to place an order for the patient in the Order Patient Samples page), Collect Samples (to collect samples for all orders for the patient that are ready for collection), Blank Patient Requisition (to view or print a blank requisition from the View PDF page), Patient Labels (to print the system default patient-type labels), or Change Log (to view the change log for the selected patient on the Change Log page, if you have the rights to do so). When creating blank requisitions, Copia will attempt to use the format selected for your signed in location, if available. If not, Copia uses the system default format. If the location's format is set to use the system default, and if the system default format is set to "None," then Copia disables access to create blank requisitions.
3. Copia displays the patient's current insurance set summary on the Insurance Summary tab. To modify the displayed insurance set, click one of the buttons below:
   • Click the up or down arrows in the Rearrange column to change the hierarchy of the primary, secondary, and tertiary insurance defined within the insurance set. Click the Save button to make your changes take effect. Note that if the insurance set you modify has been referenced from an order that has not been cancelled and you modify the primary insurance hierarchy, then Copia automatically creates a new insurance set to represent the rearranged insurance set instead of modifying an insurance record that has been used previously.
   • Click the Select Different Insurance button to select a different, existing insurance set in the Patient Insurance Sets page. See the Patient Insurance Sets topic.
   • Click the Create New Insurance button to create or modify insurance plans and/or companies. See "Adding or Modifying Insurance Plans" below.
4. If there is no existing insurance information for the patient, click the Add Primary Insurance button to add insurance for the patient. See "Adding or Modifying Insurance Plans" below.
5. If you select a different set or create a new insurance plan, Copia ultimately displays the new insurance set in the patient's Insurance page.
6. If you are viewing the Insurance page as a pop-up window (see "Accessing this Page" above), the following buttons are also available:
• Close Window: Click this button to close the page and return to the preceding page.
• X: Click this button to close the page and return to the preceding page.
• ? (Help): Click the help button on the pop-up window to view the help for the Insurance page. Note that if you use the help hotkey from the pop-up, it will open the help for the Order Patient Samples page.
7. For existing, new, or modified insurance plans, modify insurance set details on the Primary, Secondary, or Tertiary tabs, and add or modify guarantor information on the Guarantor tab. See "Adding or Modifying Insurance Plans" or "Adding or Modifying Guarantor Information" below.

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Adding or Modifying Insurance Plans

Copia allows you to enter up to three insurance plans for each insurance set. Click Primary, Secondary, or Tertiary tabs at the top of the page to enter the insurance plan information. Note that the Tertiary tab is not available until there is a secondary insurance plan, and that Copia alerts you to inactivated insurance companies or plans at the top of the page. Depending on the settings on the System Defaults or Insurance administration pages, one or more of the insurance fields may be required. Required fields are indicated with asterisks (*). Note that a system administrator may assign a security right to one or more roles to disregard required fields, if appropriate.

1. Enter one or more characters in the Insurance Company or Insurance Plan search fields and either click the Search button to locate the patient's insurance company or plan in the Insurance Search page or press the "Enter" key to select a patient's insurance company or plan. You may also perform a search to select a different plan for the company in the Insurance Search page. See the Insurance Search topic. Depending on the settings in the System Defaults administration page, the Insurance Company field and search feature may be hidden. If there are no search results or if you cannot find the desired company or plan, then search again, or return to the Insurance Summary tab to add a new insurance company and/or plan. Select an option from the Insurance Type drop-down to select the type of insurance for the patient. The drop-down list defaults to "All," which does not filter by insurance type. See "Viewing or Selecting Patient Insurance Sets" above. Note that
• This search allows you to verify that the insurance company or plan you wish to create does not already exist before creating a new plan.
• If you attempt to change the primary insurance plan for an insurance set that has been used in an order, Copia creates a new insurance set for the patient with the current primary, secondary, tertiary, and guarantor information after you select a different insurance.
2. Once you have selected or created an insurance company or plan, Copia displays the selected plan information, if available, in the Insurance Plan page. Use this page to view, create, or edit company or plan information. Click Select or Update and Select to continue. See the Insurance Plan topic.
3. After you select the insurance plan, Copia displays the selected plan in the patient's Insurance page.
4. For each insurance plan, complete the Insured Information fields listed below to create or modify the patient's insurance file.
• Policy: Enter the policy number for the patient's insurance.
• Group: Enter the name of the group to which the employer belongs.
• Group #: Enter the identification number for the group to which the employer belongs.
• Relationship to Insured: Select the option that describes the relationship of the insured individual to the selected patient. This field is required. If you select "Self," Copia asks if it should automatically fill in the patient's demographic information. If you select one of the other options, Copia asks if it should automatically fill in the patient's phone and address information. Click OK to have the patient's information entered automatically, or click Cancel to manually enter the information.
• First Name/Middle Name/Last Name: Enter the name of the individual who carries the insurance policy. The Last Name field is required.
• Subscriber ID: If applicable, enter an identification number used by the selected insurance set.
• Sex: Select the sex of the insured individual from the drop-down list. When creating a new patient record and the Sex field is not required, Copia populates the field with the undeclared value, but if it is a required field, Copia displays a blank until you select the appropriate option.
• Date of Birth: Enter the birth date for the insured individual in the format of MM/DD/YYYY. If this field is required, you may have the security right to enter zeros in place of a date of birth to indicate that the date of birth is not known or required. The field will appear in red if it is empty or the value is invalid, until you correct the entry.
• Phone #1/Phone #2: Enter the telephone contact information for the insured individual.
• Address 1/Address 2/Zip Code/City/State/Country: Enter the full address for the insured individual, including any apartment or suite numbers. If zip code checking is enabled in the System Defaults administration page, then, when you enter a zip code that exists in the database, Copia automatically fills in the city and state associated with the zip code, and if the zip code update option is enabled, then Copia also updates the corresponding city and state data, if appropriate.
• Employment Status: Enter the employment status for the insured individual.
• Insured SSN: Enter the Social Security Number for the insured individual.

Depending on the system default, location, or insurance administration settings, Copia may consider one or more of the insurance fields required and/or require certain numeric/alphanumeric patterns for policy numbers, groups, and group numbers. See the Admin: System Defaults, Admin: Locations, or Admin: Insurance topics.

5. For each insurance plan, complete the Employer Information fields listed below to create or modify the patient's insurance file.
• Employer: Enter the name of the employer providing the insurance.
• Employer ID: Enter the identification number for the employer providing the insurance.
• Employer Plan Code: Enter the employer's insurance plan code.
• Employer Phone #: Enter the employer's phone number.
• Address 1/Address 2/Zip Code/City/State/Country: Enter the full address for the insured individual's employer, including any suite numbers. If zip code checking is enabled in the System Defaults administration page, then, when you enter a zip code that exists in the database, Copia automatically fills in the city and state associated with the zip code, and if the zip code update option is enabled, then Copia also updates the corresponding city and state data, if appropriate.
6. Click Load Image to add a picture to the patient's file for the selected insurance plan. See "Adding, Updating, or Deleting Photos" below. If you have already added a photo, Copia displays a thumbnail-sized version of it next to the Load Image button. Click the image to see the full-sized version. When you are done viewing the image, click the Close button, click the image, or click the X button in the top corner of the pop-up window.
7. Click Clear at any time to remove the contents of all of the fields for the corresponding insurance plan. Once you click Clear, Copia asks you to confirm discarding the changes. Click OK to clear the information, or click Cancel to return to the Insurance page without clearing information. Once Copia clears the information, it temporarily keeps the insurance position open for a new entry to replace the one you cleared. If you do not enter new information before you click Save, Copia shifts lower insurance, if available, one position to the left to fill the vacancy, which is the same behavior as the Remove button (see below). If you attempt to change the primary insurance plan for an insurance set that has been used in an order, Copia creates a new insurance set for the patient with the current primary, secondary, tertiary, and guarantor information after you select a different insurance.
8. Click Remove at any time to remove the currently viewed insurance (primary, secondary, or tertiary) from the currently selected set and to shift lower insurance one position to the left. For example, if you remove the secondary insurance, the tertiary insurance becomes the new secondary insurance.
9. Click Save to record the changes.
10. Depending on the system default administration settings, Copia may automatically fill in patients' guarantor information with their current demographic information when you select "Self" as the relationship to insured for the patients' primary insurance without entering other guarantor information. See the Admin: System Defaults topic.
11. Click Discard Changes to clear any changes made to the insurance plan.

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In order to use the insurance photo feature, a Copia System Administrator must enable it in the System Defaults administration page. See the Admin: System Defaults topic.

1. Once the insurance photo feature is enabled, the Load Image button is available for patients on the Primary, Secondary, or Tertiary tabs.
2. Click the Load Image button to open the patient image page, where you may add, update, or delete patient images. See the Images topic.
3. After you load an image, click the Save button on this page to save the image in the patient's file. If you do not save the image this way, Copia will not retain the image in the file.
4. Once you have loaded the image, Copia displays the photo on this page, as well as on reports or other printed documents that include the insurance photo in the layout template. See the Admin: Layout Templates topic.

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Adding or Modifying Guarantor Information

1. Complete the fields listed below to create or modify guarantor information.
• Relationship to Insured: Select the option from the drop-down list that describes the relationship of the selected patient to the insured individual. If you select "Self," Copia asks if it should automatically fill in the patient's demographic information. If you select one of the other options, Copia asks if it should automatically fill in the patient's phone and address information. Click OK to have Copia enter the patient's information automatically, or click Cancel to manually enter the information.
• First Name/Middle Name/Last Name: Enter the name of the guarantor.
• SSN: Enter the Social Security Number of the guarantor.
• Sex: Select the sex of the guarantor from the drop-down list.
• Date of Birth: Enter the birth date for the guarantor in the format of MM/DD/YYYY.
• Phone #1/Phone #2: Enter the telephone contact information for the insured individual.
• Address 1/Address 2/Zip Code/City/State/Country: Enter the full address for the insured individual, including any apartment or suite numbers. If zip code checking is enabled in the System Defaults administration page, then, when you enter a zip code that exists in the database, Copia automatically fills in the city and state associated with the zip code.
2. Click Clear at any time to clear all of the fields for the guarantor. This action resets all of the fields to blank values. Copia prompts you to confirm that you wish to permanently remove the information.
3. Click Discard Changes to clear any changes made to the guarantor information. This action only clears any changes you have made to fields since the last time you saved the guarantor information.
4. Click Save to record the changes.

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