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Add, Edit, or Remove Insurance Case Conditions

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Updated: 06/23/2023 | Views: 1229

The Condition tab of a patient's case is used to enter information about the cause that prompted the need for healthcare services; this type of information is sometimes required for certain types of claims.

Access Patient Insurance Case

  1. Enter the first 2–3 letters of the patient's name or date of birth (mm/dd/yyyy) in the top navigation bar search box.
  2. Click to select the patient from the auto-populated results. The patient's Facesheet page opens.
  3. Click Account. The Account page opens.
  4. Click the Insurance tab. The Insurance page opens.
  5. Click Edit. The Edit Insurance Case page opens.
 Platform_InsuranceCase_Edit.png

Add Conditions

  1. Click the Conditions tab. The Conditions page opens.
  2. If applicable, click to select whether the patient condition is related to: "None", "Auto Accident", "Employment", or "Other accident".
    • If "Auto Accident" is selected, click to select the state from the drop-down list.
  3. If applicable, click to select whether the service provided is related to: "Pregnancy", "EPSDT", "Family planning", "Homebound", or "An emergency".
    • If "EPSDT" is selected, select the referral status from the drop-down list.
  4. Under the Add events related to condition section:
    • Enter the Date or Date Range.
      Note: The Type of date auto-populates based on the previous selection's requirements.
    • To add an additional event, click Add event.
    • To remove an additional event, click Delete.
  5. Click Save & Finish when done.
 Platform_Conditions_Add.png

Edit Event Date

If the save event date in incorrect, update the condition date.

  1. Click the Conditions tab. The Conditions page opens.
  2. Enter a new Date or Date Range.
  3. Click Save & Finish when done.
 Platform_Conditions_EditDate.png

Edit Conditions

If the incorrect patient condition or service provided was selected, update the selection and event date.

  1. Click the Conditions tab. The Conditions page opens.
  2. Update the Patient Condition or Service Provided selection:
    • To select a new patient condition is related to, click to select "None", "Auto Accident", "Employment", or "Other accident".
      • If "Auto Accident" is selected, click to select the state from the drop-down menu.
    • To select a new service provided, click to select "Pregnancy", "EPSDT", "Family planning", "Homebound", or "An emergency".
      • If "EPSDT" is selected, select the referral status from the drop-down.
    • To remove a Service Provided, click to clear the selection.
  3. Under the Add events related to condition section, enter the Date or Date Range for the new Patient Condition or Service Provided.
  4. If necessary, click Delete to remove the previous event(s).
  5. Click Save & Finish when done.
 Platform_Conditions_Edit.png

Remove Conditions

If the patient condition or service provided was selected in error, remove the selection and event date.

  1. Click the Conditions tab. The Conditions page opens.
  2. Remove a Patient Condition or Service Provided:
    • To remove a Patient Condition, click to select "None".
    • To remove a Service Provided, click to clear the selection.
  3. If necessary, click Delete to remove the event(s).
  4. Click Save & Finish when done.
 Platform_Conditions_Delete.png