Click the Edit button to Edit an existing policy (select the existing policy from the drop down list)
When you select New, the Who is the Insured window opens:
Who is the Insured?:
This patient (self): Select this option if the patient is the insured. "Self will be checked for HCFA / CMS Box 6
Another Patient: Select this option if the patient's relationship to the Insured is that of a spouse, child or other and the Insured is also a patient in Quixote. You determine which option will be checked in the HCFA / CMS Box 6 when you edit the policy.
A Non Patient: Select this option if the patient's relationship to the Insured is that of a spouse, child or other and the Insured is
NOT a patient in Quixote. You determine which option will be checked
in the HCFA / CMS Box 6 when you edit the policy.
A Company: Select this option if the Insured is a company and the Case is Workers Compensation. "Other" will be checked
in the HCFA / CMS Box 6
Note: This is NOT the Insurance Company / Payor. This is the Employer.
Note:The Insured is also known as the "Policy Holder" or "Subscriber"
Patient is the Insured:
If the patient is the insured click This patient (self) and then Next:
The Payor window opens. Select the Payor for this Policy.
Click the Next button
The Add Policy window opens
Adjuster: Enter the name of the Adjuster (This is for your information only)
Adjuster Phone Number: Enter the Adjuster's Phone Number
Adjuster Extension: Enter the Adjuster's Phone Extension
CoPay Amount: Enter the Patient CoPay amount. Ex.: $5, $10, $15. Do not use the $ sign.
Insurance Percentage: Enter the Insurance percentage amount. This is the amount owed by the Payor / Insurance Co. Ex.: 80%, 90%. Do not use the % sign.
Enter either
a CoPay amount or
an Insurance Percentage amount. (NOT
BOTH) If the patient has a CoPay, do not
enter zero in the Insurance Percentage field.
Number of Visits Allowed: Enter the number of visits allowed for this policy
Quixote will
generate an alert, when 2 visits remain
Number of Visits Used: Enter the number of visits used
Note: This is
usually left at zero, however, if the patient has already used visits from the
number of visits allowed, enter that number.
Dollar Amount Allowed: Enter the dollar amount allowed for this policy
Dollar Amount Used: Enter the dollar amount used for this policy
Note: If the patient has already used a portion of their allowed dollar amount, enter that dollar amount
Deductible: Enter the Patient's Deductible
Deductible Remaining: Enter the Remaining Deductible
Note: If the patient has not used any of their deductible, enter the same amount in both Deductible and Deductible Remaining
Reset Date: Enter the Deductible Reset Date
Note: Quixote allows
you to enter any date here, as not all policies reset at the end of the year. The deductibles will Reset automatically.
Insured's Policy Group or FECA Number: Enter the Insured's Policy Group or FECA Number. This will print in Box 11 on the HCFA / CMS form.
Insurance Plan Name or Program Name: Enter the Insurance Plan Name or Program Name. This will print in Box 11c on the HCFA / CMS form.
Insured's ID Number: Enter the Insurance Plan Name or Program Name. This will print in Box 1a on the HCFA / CMS form.
Relationship to Insured: Select Relationship from the drop down list. This will print in Box 6 on the HCFA / CMS form.
Note: If the Insured is the patient, Quixote defaults to "Self"
Is there another health benefit plan?: (Secondary) Select Yes, if there is a Secondary Insurance Policy
Contract / Allowed Amounts: (Only Use for Primary Payor) If there is a Contract / Allowed Amount for this Payor / Policy, select the Contract / Allowed Amount from the drop down
Click the Finish button
Patient Insurance / Insureds Information Tab: To view the information for this policy click the Insured's Information Tab.
