Primary, Secondary, and Tertiary Insurance Pull Fields

Primary insurance refers to the first insurance listed in the Patients Ability > Patient > Insurance tab, secondary insurance refers to the second insurance listed, and tertiary insurance refers to the third insurance listed. Any more insurances listed on the insurance tab cannot be pulled into the note without moving them to the primary, secondary or tertiary position. If an insurance carrier is not enabled it will not be pulled into the note.

All insurance information is set in the References Ability > Insurance Companies, unless otherwise noted:

  • Insurance Carrier: Insurance Company name

  • Insurance Plan Name: Insurance plan, as selected in the Insurance table of the Primary or Secondary tab. This information can be changed under the Plans tab of the insurance reference.

All Insurance Address information will pull from the Company Info tab of the insurance reference if the patient is not associated with a plan. If the patient has a plan, it will pull from the Demographic sub-tab (found under the Plans tab of the insurance reference) of the plan record.

  • Insurance Street Address: Insurance company (or plan's) street address

  • Insurance Suite: Insurance company (or plan's) suite or apartment number; will only display the data in the field

  • Insurance City: Insurance company (or plan's) city

  • Insurance State: Insurance company (or plan's) state

  • Insurance Zip Code: Insurance company (or plan's) zip code

  • Insurance Plan Type: Insurance company (or plan's) type, as selected in the Plan Type pop-up menu.

  • Insurance Phone: Insurance company (or plan's) phone number

  • Insurance Phone Extension: Insurance company (or plan's) extension

  • Insurance Fax Number: Insurance company (or plan's) fax number

  • Insurance Contact Person: Contact Person, listed under the Company Info tab.

  • Insurance Plan Contact Person: pulls from the selected carriers insurance company reference > Plans tab > Demographic tab > Contact Person field.

The Insurance Is pull fields will are true/false pull fields that will display T if the plan type is set to the noted plan type, and F if it is set to anything else. If the patient is associated with a plan, this will pull based on the Plan Type pop-up button in the Plan record. If the patient is not associated to a plan, the Plan Type pop-up button on the Company Info tab of the insurance record will be used. After each pull field is the plan type that must be selected for the selected field to pull T.

  • Insurance Is Medicare: Medicare Part B

  • Insurance Is Medicaid: Medicaid

  • Insurance Is Champus: Champus

  • Insurance Is ChamVA: Veteran Administration Plan

  • Insurance Is Group Health Plan: Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), or Health Maintenance Organization

  • Insurance Is FECA: Other Federal Program

  • Insurance Is Other Plan Type: Self-Pay, Central Certification, Other Non-Federal Programs, Point of Service (POS), Indemnity Insurance, HMO Medical Risk, Automobile Medical, Blue Cross/Blue Shield, Commercial Insurance Co., Disability, Liability, Liability Medical, Title V, Workers Compensation Health Claim, or Mutually Defined Unknown

The following pull based on the information listed the Patients Ability > Ledger > Incident > Prior Auth tab. It will only be pulled to the note if the relevant insurance is selected in the Insurance popup menu of the Prior Authorization record. That is, if the primary pull fields are used, the patient's primary insurance must be selected, for secondary fields the secondary insurance must be selected, and so on.

  • Insurance Has Prior Authorization: True or false pull field that will display T if there is a prior authorization added to the Prior Auth. tab of the incident on the Ledger tab of the patient ability and the above conditions are met. F will be displayed if there is no prior auth record, or if it is not tied to the insurance.

  • Insurance Prior Authorization: Prior Authorization number

  • Insurance Prior Auth Total Visits: Total visits for the prior authorization

  • Insurance Prior Auth Visits Remain: Remaining visits for the prior authorization record

  • Insurance Prior Auth Exp Date: Expiration date of the prior authorization

  • Insurance Plan Note: This will pull the information in the Notes tab of the plan record. If the patient does not have a plan, this pull field will not pull any information.

The Policy Holder pull fields will pull from either the Primary or Secondary tab of the Patient ability, depending on which tab the insurance is listed under. For example, a patient could have three insurances: Blue Cross (primary), United Healthcare (secondary) and Aetna (tertiary). Blue Cross and Aetna are listed under the Primary tab, and United Healthcare is listed under the Secondary tab. If the Primary or Tertiary Policy Holder pull fields are used the information listed under the Primary tab of the Patient ability will be listed. If the Secondary Policy Holder pull field is used the information listed under the Secondary tab will pull to the note. Unless otherwise noted, the name of the pull field is the name of the field under the relevant record.

  • Policy Holder Last Name: Policy holder's last name

  • Policy Holder First Name: Policy holder's first name

  • Policy Holder Middle Name: Policy holder's middle name

  • Policy Holder Prefix: Policy holder's prefix

  • Policy Holder Suffix: Policy holder's suffix

  • Policy Holder Street Address: Policy holder's street address

  • Policy Holder Suite: Policy holder's suite or apartment number; will display only the field's data

  • Policy Holder City: Policy holder's city

  • Policy Holder State: Policy holder's state

  • Policy Holder Zip Code: Policy holder's zip code

  • Policy Holder Home Phone: Policy holder's phone number associated with the Home phone pop-up button as entered in one of the phone fields

  • Policy Holder Work Phone: Policy holder's phone number associated with the Work phone pop-up button as entered in one of the phone fields

  • Policy Holder Other Phone: Policy holder's phone number associated with the Other phone pop-up button as entered in one of the phone fields

  • Policy Holder Mobile Phone: Policy holder's phone number associated with the Mobile phone pop-up button as entered in one of the phone fields

  • Policy Holder Date of Birth: Policy holder's DOB

  • Policy Holder SSN: Policy holder's social security number

Unless otherwise noted, the following fields will pull from the corresponding field in the Patients Ability > Primary/Secondary tab > Insurance table:

  • Policy Number: Insurance policy number

  • Person Subscriber Number: Subscriber number

  • Patient Subscriber Number: Subscriber number, as entered in the insurance table of the Patient tab

  • Group Number: Policy #. If there is an employer associated to the insurance, the group number must be changed in the Employers table of the Primary/Secondary tab.

  • Division/Section Number: Division/Section number

Unless otherwise noted, the following fields will pull from the Patient's Ability > Patient > Insurance tab:

  • Start Date: Patient's start date

  • End Date: Patient's end date

  • Renewal Date: Patient's renewal date

  • Remaining Deductible: Patient's remaining deductible

  • Remaining Coverage:��Patient's remaining coverage

  • Copay: Patient's copay

Unless otherwise noted, the following fields will pull from the Employer listed in the Employers table of the Primary or Secondary tab. This information can be changed in the References Ability > Employers.

  • Employer Name: Employer's name

  • Employer Address: Employer's street address

  • Employer Suite: Employer's suite; will only display the field's data

  • Employer City: Employer's city

  • Employer State: Employer's state

  • Employer Zip Code: Employer's zip code

  • Employer Phone: Employer's phone number. This is defaulted in the employer's reference, but can be edited on a per-account basis under the Primary or Secondary tab.

  • Employer Extension: Employer's extension. This is defaulted in the employer's reference, but can be edited on a per-account basis under the Primary or Secondary tab.

  • Employer Group Number: Employer's group number. This can be edited on a per-account basis under the Primary or Secondary tab