Box 11d specifies if there is another health benefit plan attached to this claim. Only one box can be marked.*
To change or add patient's additional payer Health Benefit Plan information on the claim form:
Navigate to the Patient>Treatment Episodes>[Select Treatment Episode]>Intake
- From the Intake tab, click on the Insurance sub-tab and click on the blue link below "Secondary". In this example, 1199 National Benefit Fund is the secondary insurance payer.
- If there wasn't a secondary payer created yet, then there would be a blue [Create] link to click on.
- Select the new secondary payer from the dropdown list, or click on the Add New Payer and select the payer name if the payer is not listed.
- If the payer needs to be added, then type the payer name in the filter box and select the payer name from the filter list. If the payer name does not appear on the filter list, then click on the dropdown list and select the payer name from the dropdown list. Or, if the payer name is not listed then create the payer for paper claims by clicking on the blue link "Create Payer for Paper Claims".
- The following fields will need to be filled out for a paper claim payer.
This box does not correspond to an element of an 837 file.