OfficeMate Home Office User's Guide - OfficeMate Software Solutions

Setting Up Insurance Carriers
Chapter 2 Setting Up Insurance Carriers & Plans
Select the type of provider identifier that displays on the CMS 1500 from the
Box 25 Tax ID drop-down menu.
Notes
• The default for insurance carriers that were included in data that
was converted from OfficeMate 8.0 and below or OfficeMate
Enterprise 1.0 and below is Location Tax ID.
• If the carrier is VSP, select Doctor’s EIN from the Box 25 Tax
ID drop-down menu.
Select Yes from the Box 27 Accept Assignment radio buttons to accept
agreed upon payments directly from the insurance carrier. Click No to not
accept the assignment.
Select Yes from the Box 29 Indicate Patient Payment on Claim radio
buttons to populate the CMS 1500 form with the patient’s payment. Click No
to not include the patient’s payment.
Select Yes from the Secondary Claim Recipient, remaining charges
only radio buttons to display only the remaining charges on the CMS 1500 when
this insurance is the secondary. Select No to populate the CMS with the original
charges.
If you opted to show the original charges on a secondary claim in step 15, select
Yes from the Populate Patient’s & primary insurance payment radio
buttons to include payments received from the patient and primary insurance on
the CMS 1500.
Select Yes from the UB04 not applicable. Use CMS 1500 only radio
buttons if this insurance carrier does not accept UB-04 claim forms.
Select a policy from the Policy Type drop-down menu.
Notes
• The default for insurance carriers that were included in data that
was converted from OfficeMate 8.0 and below or OfficeMate
Enterprise 1.0 and below is Other.
• You do not need to select or modify the policy type to process
insurance claims.
• If the carrier is VSP, select Other from the Policy Type
drop-down menu.
Select an agreement type from the PPO/HMO drop-down menu.
Select an output for claims to this carrier from the Output drop-down menu.
Note
If the carrier is VSP, select CMS 1500 Form from the Output
Format drop-down menu.
112 OfficeMate Home Office User’s Guide