Insured Party Relationship Default Setting

Idea created by annag on Oct 25, 2017
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    • catzadra

    Currently, if you are entering an insurance plan on a converted patient, Patient Relation defaults to "Self." However, if you enter an insurance plan from a new patient (not yet converted / no account opened yet) from the Scheduler, this field does not default to anything and is left blank until you select the appropriate field. 

     

    I would love to have "Self" not be the default of the insured party for all patients. You could add this as a setting to change the default for each practice, but for our purposes, we would like this field left blank to force the person entering the insurance information to make a selection.

     

    What tends to happen is "Self" gets left selected in error and when that happens, sending an electronic claim drops all patient information (name, DOB, etc.) and only the subscriber info is transmitted. The claim processes under self instead of the child or spouse and pays under the wrong person. This is a frustrating correction to make for us and for patients, as it can affect claims paid at other providers, etc.

     

    As an aside, the only choices insurance plans accept for this field are self, child, or spouse, or other. In my experience "other" does not go through for the majority of payers and you must select one of the other three options. This is also frustrating b/c WinOMS has many many options but in practice we only want one of three to be selected and there is no way to deactivate options in this field or recode them to be one the approved options (most code to "other" on the insurance claim whereas we need life partner to list as spouse, adopted child to list as child, etc.).