Patient Section

The Patient section allows you to add and edit your patient demographics, insurance, claim information, and documents, as well as check eligibility and view patient appointments.

The following help pages are supported by the current version of CollaborateMD. Please follow the curriculum outline to receive the proper training associated with this section.

Patient

Additional Info

Insurance

Claim Defaults

Patient Billing

Activity

Eligibility

Appointment History

Documents



Button Overview

Below you will find a description of the buttons located within the Patient section:
  • Save: Selecting this button will save your patient information.
  • Close: Selecting this button will close the patient without saving the information.
  • Print: Selecting this button will display your print options. 
  • Merge: Selecting this button will open the Merge Accounts window.
  • Open in EMR: Selecting this option will open the Patient in the EMR if you have one.
  • Track: Selecting this button will allow you to track the patient in the Control section of the application.
  • Review: Selecting this button will review the patient.

Insured

Add Insured + Payer

Insured parties and payers can be added while creating a new patient or after a patient has been saved. While creating a New Patient or after you've found the patient's account. Follow the instructions below to add an insured and payer to a patient record:
  1. Go to the Patient section. 
  2. You can search for patient in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click the (?)  for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, click Add Insured + Payer
  5. Select the Patient's relationship to the insured
  6. Expand the Employer Information pane and begin adding any applicable information.
  7. Click on the Priority drop-down menu and select the priority level of the payer (Primary, Secondary, Tertiary). 
  8. Click on the magnifying glass beside the Payer field and select one of the following options:
    1. Find Payer: Select this option to search for a payer that has already been added to your CollaborateMD payer list. 
    2. New Payer: Select this option if you've confirmed that the payer does NOT already exist within CollaborateMD. 
  9. Begin entering information such as Member ID, Group ID, Policy Type, Copay, Co-Insurance, and Deductible, as well as an Effective and Termination date (if applicable). 
  10. When you're satisfied with your changes click Add
  11. After you've confirmed your changes, click on the Save button. 
http://training.collaboratemd.com/helppages/patient/insurance-9-4

Add Insured

To add an additional Insured party, follow the instructions below:

  1. Go to the Patient section. 
  2. You can search for patient in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click the (?)  for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, click Add Insured.
  5. Select the Patient's relationship to the insured
  6. Expand the Employer Information pane and begin adding any applicable information. 
  7. When you're satisfied with your changes click Done Editing
  8. After you've confirmed your changes click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Address Verification

Address verification allows users to validate addresses against the USPS database in order to make corrections before claims, statements, or even letters are sent to the patient. The system will automatically verify the address for the selected sources in the Admin section. Note: This feature will only determine if the address is an address on file with USPS. 

To verify an address entered as the patient's insured:

  1. Go to the Patient section and create or open the desired patient.
  2. Click Review or Save.
  3. Do one or both of the following:

    • If you clicked the Save button, you will have to reopen the record to confirm which address is invalid (if applicable).

    • Click on the the tab denoted in red font to find the source with the invalid address. Invalid addresses are highlighted in Yellow in either the Patient, Insurance, or Patient Billing tab

  4. If the address is invalid, hover your mouse over the address field to see if a suggested address is available. 
    • Click Yes to apply the suggested address

    • Click No to leave the address as is

    • Click Ask Me Later to be reminded the next you open the patient's record


Note: If the system is unable to validate the address, you will be given an option to Ignore the address which will remove the yellow fields.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Add Payer

Follow the instructions below to add a Primary, Secondary, or Tertiary payer. Note: If an insured party doesn't already exist you won't be able to add a payer. Please add the insured party first. 

  1. Go to the Patient section. 
  2. You can search for patient in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click the (?)  for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, click Add Payer.
  5. Click the Priority drop-down menu and select the priority level of the payer (Primary, Secondary, or Tertiary). 
  6. Click on the magnifying glass beside the Payer field and select one of the following options:
    1. Find Payer: Select this option to search for a payer that has already been added to your CollaborateMD payer list. 
    2. New Payer: Select this option if you've confirmed that the payer does NOT already exist within CollaborateMD. 
  7. Click on the Insured drop down menu to select the insured party responsible for this policy. 
  8. Begin entering information such as the Member ID, Group ID, Policy Type, Copay, Co-Insurance, and Deductible, as well as an Effective and Termination date (if applicable). 
  9. To add authorization information, click Add Authorization
  10. When you're satisfied with your changes click Done Editing.
  11. After you've confirmed your changes click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Edit Insured

Follow the instructions below to edit an insured:

  1. Go to the Patient section. 
  2. You can search for patient in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click the (?)  for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, locate the insured party you wish to modify and click Edit
  5. After you've confirmed your changes click Done Editing and then click on the Save button. 

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Edit Payer

Follow the instructions below to edit a payer:

  1. Go to the Patient section. 
  2. You can search for patient in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click the (?)  for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, locate the payer you wish to modify and click Edit
  5. After you've confirmed your changes click Done Editing and then click the Save button. 

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Set Default Payer for Claims

If a patient has more than one insurance policy at the same priority level (Primary, Secondary, Tertiary), a default payer must be selected for all new claims or claim type (professional or institutional). Please keep in mind that the default payer at the selected priority will be the payer selected for all new claims created. 

Follow the instructions below to select a default payer for all claims based on the payer's priority:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, locate the payer you wish to set as the default payer and click Set as default
  5. Select from one of the following:
    1. For all claims: Selecting this option will make this payer the default payer on all new claims for this patient at the selected priority.
    2. For professional claims: Selecting this option will make this payer the default payer on all new professional claims for this patient at the selected priority.
    3. For institutional claims: Selecting this option will make this payer the default payer on all new institutional claims for this patient at the selected priority. 
  6. After you've confirmed your changes click on the Save button. 

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Inactivate Payer

Follow the instructions below to inactivate a payer on a patient record:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, locate the payer you wish to inactivate and then click Edit
  5. Check the Inactivate box. 
  6. After you've confirmed your changes click Done Editing and then click on the Save button. 

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Reactivate Payer

Follow the instructions below to reactivate a payer on a patient record:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insurance History tab, select the payer you wish to reactivate. 
  5. Once the payer is selected, click on the Set as insurance button. Note: Click on the Insured button to view the insured details associated with the insurance policy. 
  6. When the dialog window appears, select the insurance to copy to. Please note, the existing insurance information will be overwritten by the selected insurance. When you save, you may optionally archive the existing information. 
  7. After you've confirmed your changes, click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Insurance Cards

Add Insurance Card

Follow the instructions below to upload an insurance card:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4.  Locate the payer you wish to add the insurance card for and click Set Insurance Card.
  5. When the Add File window opens, locate the stored location of the scanned insurance card. Note: You will first have to configure the Documents section if it is not already. Click here to learn more about Local Storage, or here to learn more about Remote Storage. 
  6.  Once you’ve located the insurance card, click Add
  7. The insurance card is now added.  After you’ve confirmed your changes click on the Save button.

Note: When a non-image file is used, the preview image for the policy will show "No Preview Available".

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

View Insurance Card

Follow the instructions below to view an insurance card:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Locate the payer you wish to view the insurance card for, place your cursor over the image and select View

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Change Insurance Card

Follow the instructions below to replace an insurance card:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4.  Locate the payer you wish to change the insurance card for, place your cursor over the image and select Change.
  5.  When the Add File window opens, locate the stored location of the scanned insurance card.
  6.  Once you’ve located the insurance card, click Add
  7. The insurance card is now added. After you’ve confirmed your changes click on the Save button.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Remove Insurance Card

Follow the instructions below to remove an insurance card:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Locate the payer you wish to remove the insurance card for, place your cursor over the image and select Remove.
  5. After you’ve confirmed your changes click on the Save button.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Authorizations

If a patient requires preauthorization for services before they’re rendered, this information can be tracked and stored on the payer level. Multiple authorization numbers can be associated with a payer, however; only one authorization can be used on the claim for that specific payer.

Note: A pop up alert will display when an authorization number has passed its expiration date, but has not been inactivated.

Add Authorization

Follow the instructions below to add an authorization number:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, locate the payer you wish to add the authorization number to and click Add Authorization.
  5.  When the authorization window opens, enter the Authorization#Visits AuthorizedVisits Used and any other applicable information such as the Start DateEnd DateAlert days before expiration, followed by a Description of the authorization and then click Save.
  6. After you’ve confirmed your changes click on the Save button.

 https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Edit Authorization

Follow the instructions below to edit an authorization number:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, locate the payer you wish to modify the authorization number for and locate the authorization. 
  5. Click Edit
  6.  Make the necessary changes to the authorization information and then click Save.
  7.  After you’ve confirmed your changes click Save.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Inactivate Authorization

Follow the instructions below to inactivate an authorization number:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, locate the payer you wish to modify the authorization number for and locate the authorization. 
  5. Click Inactivate.
  6. After you’ve confirmed your changes click Save.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Reactivate Authorization

Follow the instructions below to reactivate an authorization number:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab.
  4. Under the Insured tab, locate the payer you wish to modify the authorization number for and locate the authorization. 
  5. Click Reactivate.
  6. After you’ve confirmed your changes click Save.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Family Accounts

Link Family Accounts

Selecting this option will link patients to a master family account which will allow for family statements to be delivered. Follow the instructions below to link family accounts:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, click Link to Family.
  5.  When the Patient Search window opens, begin searching for the patient you wish to link to the open patient record. Note: The insured must be added in CollaborateMD as a patient first. 
  6.  Select the patient’s relationship to the insured and then select Link.
  7. After you’ve confirmed your changes click on the Save button.
Important: Once the record is linked to the patients account, any modifications to the insured or insurance information must be made within the insured record. Search for the insured as you would a patient when you’re ready to make changes. 

 https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Unlink Family Accounts

Follow the instructions below to unlink family accounts:

  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab. 
  4. Under the Insured tab, click  on the “Unlink from <Insureds Name>” button.
  5.  When prompted, select what you would like to do:
    1.  Retain as active insurance: Select this option to unlink the patient from the master family account but retain the payer and member information from the original source.
    2.  Archive into insurance history: Select this option to unlink the patient from the master family account and archive the insurance. 
    3.  Remove without archiving: Select this option to unlink the patient from the master and NOT archive the insurance.
  6. Click the Unlink button. 
  7. After you’ve confirmed your changes click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Update Claims to Use Current Insurance Information

  • Update claims to use current insurance information for service dates from ___ to ___: 
    • Update policy information only (don’t change payers): Select this option if you only updated the Member ID or Group ID. 
    • Set the current default payers and policy information: Select this option if you updated the Payer, Member ID, and Group ID. 
      • A dialog will appear showing the claims that will be updated. Some claims may be re-filed. Review the listed claims for accuracy.
        1. Note: Claim refiling will only be completed for charges that are currently in one of the following statuses:
          • Send to Insurance via Clearinghouse
          • User Print and Mail to Insurance
          • At Insurance. Note: If the claim is currently in this status, the claim will be refiled to the payer that the claim is currently at unless the payer is no longer associated with the claim at the time of service. If necessary, change the payer on the claim in the Claim section.
      • Click Confirm and Save to update claims. To change the criteria without updating claims, click Cancel Update
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Assignment

  • Accept Assignment of Benefits: Click on the drop down and choose the appropriate authorized signature on file for box 12 and/or 13 on the HCFA.
  • Provider Accepts Assignment: Indicate whether or not the insured party has signed an authorization form to allow insurance benefits to be paid to the provider. If you select "No, the provider does not accept assignment of benefits" here, claims created for this option will automatically enter a "No" on the HCFA.

https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Insurance History

Archive Insurance

Follow the instructions below to archive insurance so that it appears in the Insurance History list:
  1. Go to the Patient section.
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab and make any changes to the patient's insurance. 
  4. When you're done, click on the Save button. 
  5. A dialog will appear asking if you wish to archive the insurance. Select the payer you wish to archive. Note: If the payer changed you will have the opportunity to set the termination date of the previous insurance. 
  6. Click Continue to continue saving the patient and archive the insurance selected. Note: Uncheck the box next to the insurance if you do NOT want to archive the information. 
  7. When you're done, click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Find Archived Insurance

Follow the instructions below to find archived insurance information for a patient:
  1. Go to the Patient section. 
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. IN the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button. 
  3. Once the patient is open, click on the Insurance tab and then click on the Insurance History sub-tab. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Set Archived Insurance as Current Payer

Note: Existing insurance information will be overwritten by the selected insurance. When you save, you may optionally archive the existing information.

Follow the instructions below to set an archived insurance as the patient's current insurance:

  1. Go to the Patient section. 
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities.
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open.
    4. Click on the Advanced Search button. 
  3. Once the patient is opened, click on the Insurance tab and then click on the Insurance History sub-tab.
  4. Select the insurance from the table that you want to use as the patient's current insurance and click on the Set as Insurance button. 
  5. Select the insurance to copy to (Primary, Secondary, Tertiary) and then click OK.
  6. When you're done click on the Save button.
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4

Update Existing Claims with Archived Insurance

Follow the instructions below to update existing claims with insurance information form an archived insurance:

  1. Go to the Patient section. 
  2. You can search for patients in one of four ways:
    1. Use the Search field provided to search by name, phone#, and more. Click on the (?) for all search capabilities. 
    2. Click on the Open <Patient Name> button to open the active patient. 
    3. In the Recently Opened pane, select the patient you wish to open. 
    4. Click on the Advanced Search button.
  3. Once the patient is opened, click on the Insurance tab and then click on the Insurance History sub-tab.
  4. Select the insurance from the table that you want to use as the patient's current insurance. 
  5. Click Update Existing Claims
  6. Select the method you wish to use to update claims:
    1. Update claims where <Payer Name> is the primary payer. 
    2. Update claims where the following payer is the primary payer. 
  7. Select all other applicable search parameters.
  8. Click Update Claims
  9. A dialog will appear showing the claims that will be updated. Some claims may be re-filed. Review the listed claims for accuracy.
    1. Note: Claim refiling will only be completed for charges that are currently in one of the following statuses:
      • Send to Insurance via Clearinghouse
      • User Print and Mail to Insurance
      • At Insurance. Note: If the claim is currently in this status, the claim will be refiled to the payer that the claim is currently at, unless the payer is no longer associated to the patient. If necessary, change the payer on the claim in the Claim section.
  10. Click Confirm and Save to update claims. To change the criteria without updating claims, click Cancel Update
  11. When you're done click on the Save button. 
https://sites.google.com/a/collaboratemd.com/training/helppages/patient/insurance-9-4