Creating HCFA for Special Circumstances

Special Circumstances do present themselves when a HCFA is necessary to submit for an Auto Injury Case, Attorney, Etc. 

Here are the steps to Create a HCFA when an actual Insurance company cannot be entered in for a patient you have treated, but they need a HCFA to show DOS/Charges/Diagnosis Codes:

Overview of steps:

• Create a Payer in Admin
• Add insurance policy into patient's file (with the payer)

Creating a Payer in the Admin Section

Step 1: Go to Administration > Payers area

 

Step 2: Click Add button at the bottom of the page

Step 3: Create a fictitious payer that your clinic can use so that you can create a fee schedule. In this example, we named the payer 'Cash Clinic'. Add in your clinic's info, and click Save. Then your new payer will show in the Payer's list

Adding fictitious Insurance to Patients File

STEP 1:

Go to the Patient Rolodex, by selecting Patients in your main toolbar on the bottom left of the screen and find the patient's name in the Rolodex.

STEP 2: Go to the patient's Insurance Tab and Select ADD/EDIT button

STEP 3: Select Create New Policy, Click Next

Step 4: Select New Primary, Next

Step 5: Select "This Patient (self), Next

Step 6: Select Insurance Payer Created for Clinic, Next

Step 7: Entering Policy Information

In this area, you will focus on specific areas

• Insurance ID: Anything you would like to put. SSN, DOB, ACCT Number, etc.
• Relationship to Insured: Self
• Insurance percentage of covered charges: 0% = you would like the balance moved to Patient Balance OR 100% = you would like the balance moved to Payer Balance
• Select Hold HCFA Button
• Box 11d: No
• Box 27: No
• Next

Step 8:  Select Finished, Next

Step 9:  Select the Day BEFORE Charges started, Next

 

Step 10:  Select OK

 

Step 11:  Select Finished Again

 

All SET!!

 

You will need to hit the Refresh Data button in the patient's file to see the new details of the policy you just entered and the changes made to the ledger. 

Now, you can create your hcfa for your special circumstance.

If you do not know how to create a hcfa, please click HERE.

 

- Support Information -

 If you have any questions or need assistance with this process please contact Support by:

Live chat: Click the 'Support Portal' button in your main toolbar (on left-hand side) within the software, click the green 'Support' box in bottom right of screen.

***This has the fastest response time***

Phone/Text: 909-378-9514

Email: [e-mail]