Updated: 01/08/2026 | Views: 19383
Patient cases are created to manage insurance policy selection as well as the order in which two or more insurance plans are billed. Separate cases (e.g., Commercial, Self Pay, Workers' Compensation, Auto) should be created for each policy type. For example, you may have a patient that is being treated for injuries sustained from an auto accident that is covered under one insurance policy; yet that patient may receive treatment during the same visit for a condition unrelated to the auto accident and for which a different policy is billed.
Information associated with a case is organized under three tabs: General, Condition, and Authorizations. While the General tab of a new case includes basic information about the case, it's also where you add one or more insurance policies that may provide reimbursement for services related to the case.
Note: There are some payer scenarios (e.g., Attorney Lien, Workers' Comp) that will prompt the addition of the Attorneys and/or Workers' Compensation tabs.
Unless you are adding a case at the time of creating a new patient record, you typically begin with navigating to the Cases tab (of the Patient record) before adding, editing, or removing a case.
Navigate to Cases
- Find the Patient record then double click to open. The Edit Patient window opens.
- Select the Cases tab. The Cases tab information displays.
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Add New Case
One or more cases can be added to the Patient record either at the time of creating a Patient record or at a later time to an existing patient record.
- To prevent duplication, navigate to Cases and verify the case is not in the system.
- Click Add on the right of the window. The General tab of the New Case window displays by default.
- Enter the General tab information.
- Name and Description: The name for the case that will help distinguish it from other cases, and if applicable, a brief description about the purpose or use of the case (e.g., the condition for which the patient is being seen).
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- Referring Provider: If applicable, auto-populates from the Patient record.
- To search and select a provider, click Referring Provider. If the provider is not listed, click New at the bottom of the Select Referring Physician window and create a new Referring Physician.
- "Active?": Selected by default. To change the case to inactive at any time, click to clear the selection.
- "Send patient statement?": Selected by default and allows statements related to the case to be sent to the patient. To prevent patient statements from being sent, click to clear the selection.
- Payer Scenario: Click the drop-down arrow to select the payer scenario.
- "Show expired policies?": Click to select to see expired insurance policies for this case.
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- Enter additional information for the case as applicable.
- To add an insurance policy, click Add under the Insurance section.
- To enter information about the cause that prompted treatment, select the Condition tab.
- To add authorization information from the insurance that documents approval for medical services, select the Authorizations tab.
- If the Payer Scenario is related to an attorney lien, select the Attorneys tab to add attorney information.
- If the Payer Scenario is related to workers' compensation, select the Attorneys tab and then the Workers' Compensation tab to add the information.
- Click Save at the bottom of each relevant window until it is no longer available.
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Edit Case
- Navigate to Cases then double click the case to open. The General tab of the Edit Case window displays by default.
- Make the necessary changes to:
- Click Save at the bottom of each relevant window until it is no longer available.
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Remove Case
- Navigate to Cases then click once to select the case.
- Click Remove. A confirmation pop-up appears.
- Click Yes to confirm the removal. The case is deleted.
Note: Only cases with no other records associated, such as an encounter or appointment, can be deleted.
- Click Save.
- If the deleted case was the only patient case, a Warning pop-up appears.
- To add a new case, click Yes.
- To continue to save the deletion of the only patient case, click No.
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