You are entering insurance information for a patient using Insurance Cards. The insurance cards that you have entered for a patient are shown on the add / edit client form in Therabill (see image to the right). Therabill does an brief initial error check of the insurance card every time you add an insurance card or edit the insurance card. This error check is only looking for missing information that is probably important for claims submissions.
What does it mean when the insurance card is highlighted in red?
If Therabill detects any missing information on the insurance card, it will highlight it in red (see image to the left). This missing information may cause claim rejections. Therabill is not telling you that your claim will be rejected if you send it with the current information, it is simply saying that a field is missing that is known to cause rejections from a lot of insurance companies.
What missing fields will cause Therabill to highlight it in red?
Therabill will highlight the insurance card in red if any of the following fields are missing. Therabill receives quite a bit of support tickets asking why certain missing fields cause the red highlight box. The answer is that we are simply going by trends in rejections that we see and we are trying to take measures to get you paid as fast as possible. The biggest example of this is the subscribers date of birth. Insurance companies, in the past, have been very relaxed on this field. Recently, there have been a lot of rejections due to missing or incorrect subscriber dates of birth. For this reason, Therabill began highlighting the insurance card in red if the subscriber date of birth is missing.
- Subscribers first or last name.
- Subscribers date of birth (NOTE: This field used to be ignored. However, recently Therabill has seen a large trend in insurance companies rejecting claims due to invalid, incorrect, or missing subscriber date of birth).
- Subscribers gender.
- Address information.
- Insurance company (if you have not associated the insurance card with an insurance company).
- Responsibility (make sure you indicate if the card is primary, secondary, tertiary..etc).
- Primary ID. The primary ID is very important. It goes by different names (Member ID, Subscriber ID..etc.). This is the unique identifier of the insured and is what goes in to Box 1A of the CMS-1500. Without this number, your claim would surely be rejected.