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Kareo Help Center

Add Patient Insurance Case and Plan/Policy

  1. Last updated
    11:47, 2 May 2017
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Watch a demonstration of the features covered in this article in our Add Patient Insurance video.

Add patient insurance information in Kareo to manage policy information, add authorizations, and check eligibility. Basic insurance information can be entered when creating a new patient record, and detailed insurance information can be added to an existing patient's chart from the Account page. 

Navigate to the Patient Account Page

  1. Enter the first 2–3 letters of the patient's name in the top navigation search box.
  2. Click to select the patient from the auto-populated results. The patient's chart opens to the Face Sheet.
  3. Click Account on the left menu. The patient's Account page opens.

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Add Patient Insurance Information 

  1. Click the Insurance tab at the top of the window.
  2. Click + Add New Insurance Case.  The Add Insurance Case window opens.

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Add Case Information:

  1. Payment Method: Click to select whether the payment method is Insurance or Self Pay.
    Note: A Self-Pay case indicates a patient is paying out of pocket instead of billing an insurance company. Only the Case Information section requires completion for Self-Pay cases. 
  2. Name: Enter a name to identify the insurance case.
  3. Status: The case status is set to Active by default.
  4. Referring Provider: If applicable, begin typing the name of the Referring Provider and select it from the auto-populated results.
    Note: A Referring Provider must first be added in Practice Settings to display in this field.

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Add Insurance Policy Info:

  1. Plan Name: Enter the first 2-3 letters of the insurance plan name in the field provided and and select it from the auto-populated list.
    Note: Do not select Click to create new if the insurance plan does not display in the list. Ask your System Admin to add the plan in Practice Settings (accounts without Kareo's Billing module), or in the Desktop Application (Billing module customers).
  2. Enter the Policy Number, Group Number, insurance plan Phone Number, Copay Amount, and Deductible Amount as shown on the patient's insurance card.
  3. Click in the fields provided to select Policy Effective and Policy End dates, if available.
  4. Patient's Relationship: Click and select the patient's relationship to the primary policy holder from the drop-down menu. If the relationship is Spouse, Child, or Other, enter the policy holder/insured's information in the fields provided.
  5. Eligibility (Billing module subscribers only): Click Check Eligibility, select the patient's provider from the drop down menu in the pop-up window, and click Run Eligibility Check. The pop-up window closes and the current status displays next to Eligibility. 
  6. Notes: Enter any notes about the policy (optional).
  7. Status: The policy status is set to Active by default.
  8. Click Save Policy. The insurance policy is saved.
  9. Click Save & Finish when all information has been added. 

Click to learn how to add an authorization, formulary plan, or secondary/tertiary policy.

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