Custom Self-Pay Insurance Company and Plan

3. Select the Search Other tab. Additional options display.
4. In the Insurance search box, enter the name for the self-pay insurance company.
   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 Add Insurance window closes and the custom self-pay insurance company displays in the list of insurances.

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

3. Enter the information.
   Note: The information prints on the top right of the CMS-1500 claim form.
   • Insurance Company: Click Insurance Company to search and select the custom self-pay insurance company.
   • Plan Name: The name for the self-pay plan.
   • 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.