About the Detail-2 Tab in Insurance Maintenance

The Detail-2 tab on the Insurance Maintenance window allows you to enter additional information about the patient's insurance.

Insurance Card Name Override

Information entered in the First, Middle, Last, Suffix and Sex fields can be used to override the same information entered in demographics for the subscriber of the insurance. This information is used for claims. For example, the subscriber's name in demographics is different than the name on their insurance card.

Other information for claims includes Plan Code and TPL Code. A TPL (Third-Party Liability) code may be needed for secondary Medicaid claims.

Eligibility Verification Override

The Date of Birth field can be used to override the birth date entered in demographics for the subscriber of the insurance. If a date is entered and the Eligibility Verification check box is selected, the date will be sent on Eligibility Verification, New Referral and Referral History transactions submitted to the payer using NextGen Eligibility Verification.

Coverage

The Coverage field can be used to indicate the type of coverage provided under the subscriber's insurance. Coverage options include; Dental, Eye, Medical, Prescription, and Workers Comp.