Box 11c is the name of the insurance plan or program of the insured. Some payers require an identification number rather than the name in this field.
To change the name of the insurance plan or program on the claim form:
- Navigate to the Patient>Treatment Episodes>[Select Treatment Episode]<Intake > Insurance tab.
- Click into the insurance set (depending upon primary, secondary or tertiary).
- Click on the Change button next to the payer to be changed.
- Click on the dropdown arrow.
- Click the insurance plan name or program name from the list
- If the insurance plan name or program name is not listed, then click on the blue hyperlink "Add New Payer" and enter the insurance name in the filter field for direct listing of payer name or click the "Clearing House Payer" list to choose payer.
- Once finished, click Select.
- If the payer name is still not listed, use the blue hyperlink "Create Payer for Paper Claims", fill in all fields and click create.
Loop 2000B, Segment SBR04