Custom Self-Pay Insurance Company and Plan

3. Click the Search Other tab.
4. Enter the desired name for the self-pay insurance company in the Insurance search box.
   Note: No search results are found as this is a custom insurance.
5. Click Add. The custom self-pay insurance is added to the Selected Insurances list.
   Note: There is no payer ID assigned for custom insurance companies as these are paper claims payers.
6. Click Save. The Insurance Companies window returns and the custom self-pay insurance company displays in the list of insurances. 

2. To prevent duplication, verify the insurance plan is not in the system then click New at the bottom. The New Insurance Plan window opens.

3. Enter the information:
   Note: The below information prints on the top right of the CMS-1500 claim form.
   1. Insurance Company: Click Insurance Company to search and select the custom self-pay insurance company. 
   2. Plan Name: The desired name for the self-pay plan. 
   3. Address: Since this is a custom self-pay plan that has no claims billing address, it is recommended to enter the practice's physical address with a valid 9-digit zip code.
4. Click Save.

Next, create an additional self-pay case with a self-pay policy for the patient whose claim(s) needs to be printed.