Managing Patient Insurance Information

From the Insurance tab, you can record patient insurance information and obtain insurance eligibilities. You can also set insurances to inactive to prevent eligibilities from being obtained. This section explains how to manage patient insurance information.

Topics include the following:

  1. Open a patient profile. See Opening Patient Profiles.
  2. Click the Insurance tab.
  3. Click New Insurance to add a new insurance carrier and plan.

    A new insurance form appears with the required fields highlighted in yellow.

    If you recorded a responsible party for the patient in the Other Information window, the Responsible Party box appears asking if you want to copy the insurance and subscriber information from the responsible party’s profile. To copy the information, click Yes, select Child/Dependent from the Relationship to subscriber drop-down list, and click Save.

    The Responsible Party box does not appear if you added the patient as a dependent in the responsible party’s patient profile and copied the responsible party’s information previously.

    For information about configuring AcuityLogic to automatically incorporate responsible party updates into dependent profiles, see Adding Responsible Party Updates to Dependent Profiles.

  4. Select an insurance plan by using one of the following methods:
    • Enter or select an insurance plan in the Plan field.

      AcuityLogic populates the Carrier and Carrier Contact Information fields with the insurance carrier information from the AcuityLogic insurance database.

    • Enter or select an insurance carrier in the Carrier field and then enter or select an insurance plan available for the selected carrier in the Plan field.

      AcuityLogic populates the Carrier Contact Information fields with the insurance carrier information from the AcuityLogic insurance database.

      If the plan you are searching for is not available, select a manual plan for an insurance carrier and select the Plan is not listed check box. Selecting the Plan is not listed check box enables you to edit the information in the Carrier Contact Information fields as needed.
  5. To make the new insurance your primary insurance, select the Primary Insurance check box.
    • Patients can have more than one primary insurance plan. For example, they may have a primary vision insurance and a primary medical insurance.
    • Any plan not identified as a primary plan is a secondary plan.
    • To change a plan from secondary to primary after adding it to a patient's profile, select the plan's Primary check box in the Insurance tab's table. To change a plan from primary to secondary, deselect the check box.
  6. Select a relationship from the Relationship to subscriber drop-down list.

    Some or all of the fields in the Subscriber/Responsible Party Information section automatically populate depending on the relationship selected.

  7. Record information for the insurance subscriber in the Subscriber/Responsible Party Information section.
  8. Click Save to save the insurance information.
    • To delete saved patient insurance information, click the Delete icon in the Actions column. You cannot delete patient insurance information after the saved insurance plan is used.
    • Before deleting a patient’s insurance plan, you must remove all insurance eligibilities linked to the plan.
    • If you delete a patient’s insurance plan linked to the patient’s dependents, AcuityLogic does not remove the insurance plan from the dependent’s profile. To remove the insurance plan from the dependent’s profile, open the dependent’s profile and delete the insurance plan.
    • Deleting insurance information from a patient’s profile does not remove it from the Scheduler.
  1. Open a patient profile. See Opening Patient Profiles.
  2. Click the Insurance tab.
  3. To show only active insurances, select Active in the Insurance Status drop-down list.

    You can obtain insurance eligibilities only from active insurances.

  4. Click the Eligibilities link next to an insurance plan.

    The Eligibilities section displays.

  5. Click Add Eligibility.

    The Add Eligibility window opens.

  6. Select one or more of the Exam, Frame, Lenses, and Contact Lenses check boxes to indicate the patient’s eligibilities.
  7. Enter the authorization number received from the patient’s insurance in the Authorization # field.
  8. Enter or select the expiration date of the eligibility in the Expiration Date field.
  9. Enter notes in the Notes field, if needed.
  10. Click Save to save the eligibility information and close the Add Eligibility window.
    To delete an authorization, click the Delete Eligibility icon.
  1. Open a patient profile. See Opening Patient Profiles.
  2. Click the Insurance tab.
  3. To show only active insurances, select Active in the Insurance Status drop-down list.

    You can obtain insurance eligibilities only from active insurances.

  4. Click Check for VSP Insurance.
  5. In the Check VSP Eligibility dialog box, do one of the following:
    • If the patient is the VSP subscriber or member:
      1. Click Yes.
      2. Enter the patient’s social security number (SSN) or VSP member ID.
      3. Click Find VSP Insurance.
    • If the patient is not the VSP subscriber or member:
      1. Click No.
      2. In the Subscriber Information dialog box, enter the required information.
      3. Click Find VSP Insurance.

    If the patient has VSP insurance, the system adds the information to the table on the Insurance tab.

  6. Click the Eligibilities link in the row of the VSP carrier/plan whose eligibilities you want to authorize.

    The Eligibilities section appears:

  7. Click Add Eligibility.

    The Add Eligibility window opens.

    The window includes a list of additional VSP benefits for which the patient is eligible. To obtain authorization for any of those benefits, you first must ensure that the carrier and plan were added to the patient's profile.

  8. Do one of the following:
    • To retrieve VSP eligibility authorizations:
      1. In the window, select the eligibilities that you want to get authorization for.
      2. Click Authorize:

        AcuityLogic sends an authorization request. After the new authorization is generated, it is displayed in the Eligibilities section of the patient's Insurance tab.

    • To retrieve existing VSP eligibility authorizations:
      1. In the Retrieve Existing Authorization field, enter the authorization number you obtained from eyefinity.com or VSP member services.

        The Authorize button changes to a Retrieve button:

      2. Click Retrieve.

        AcuityLogic retrieves the existing authorization information. It is displayed in the Eligibilities section of the patient's Insurance tab.

      • To view the VSP Patient Record Report for an authorization, click the Benefit Details (magnifying glass) icon.
      • To delete an authorization, click the Delete Eligibility icon.
  1. Open a patient profile. See Opening Patient Profiles.
  2. Click the Insurance tab.
  3. Deselect the check box in the Active column to set an insurance to inactive.

    You cannot set an insurance with current eligibilities to inactive.

Related Topics