Overriding a Policy Number and Co-Pay

NextGen® Enterprise PM provides an override option for entering a patient's policy number and a co-payment that is different from the insured's co-payment amount. The override function accommodates payers who issue unique policy numbers or co-payment amounts for each individual on a single policy. To override the policy number and co-pay set up at the practice or enterprise level, you need to access the Modify Payer Information window and the Insurance Maintenance window.

You can use the override function to override a policy number and co-pay with individual policy numbers and co-pays under it. The policyholders's individual policy number is tracked on a patient basis.

An example of when this override function might be used is with a family policy. For example, the policy number for the policyholder is typically their social security number followed by a dash (-) and the numbers 01. The spouse's individual policy number would be the policyholder's social security number, followed by a dash and the numbers 02. Each dependent thereafter is also assigned an individual policy number with the policyholder's social security number, followed by a dash (-) and the last two-digits incremented by one from the oldest child to the youngest child.