This article discusses how to map insurance cards in conjunction with the WebPT EMR integration. 

When a patient is added to the WebPT EMR or a Daily Note is finalized, demographic information is sent to Therabill. Insurance cards are a part of this demographic information. If the insurance sent over has not been entered into Therabill previously, the insurance card will be unmapped. The process of mapping is to link an EMR insurance to an electronic payer ID or print and mail insurance type in Therabill.

Before You Begin

There are two important factors to consider before mapping an insurance and it all begins in the WebPT EMR.

1. You will want to make sure that your insurance profiles are specific. A patient might be insured by UnitedHealthcare, but the patient’s plan could have a different payer ID than the most common ID of 87726. One way to specify your WebPT EMR insurance profiles is to include the payer ID in the Insurance Name field. You may have multiple insurance profiles that have the same payer ID.                     
2. When an insurance card is mapped in Therabill, it becomes hard-coded in the system. This means that all patients who are given a specific insurance profile in WebPT will automatically be mapped to the payer ID that was selected initially. 
   

Who has access to view and edit insurance card mapping?

• View - Any user account with the Admin permission set to Viewable
• Edit - The Account Admin and any user with the Admin permission set to View & Edit

Mapping Insurances

1. Navigate to Admin > Defaults/Settings > Administrative.
2. At the bottom of the screen, locate the Insurance Mapping section. 
3. Search for the Note/Title that matches the insurance name in the EMR or select the View All link to display all entries.

Electronic/EDI

Follow the below instructions for Electronic/EDI or Print & Mail payers.

4. In the corresponding Payer field, enter the electronic Payer ID or begin typing the insurance name to display a drop-down with possible matches. 
5. Choose the desired entry from the list. Only select entries that include AV in the name. This ensures that your claims will be sent using our clearinghouse partner, Availity. You may see several different payers with the same name, but different payer IDs. This is one of the reasons why using the payer ID in the WebPT EMR insurance profile name is recommended. If there are multiple payers in the list with the same payer ID, it is suggested that you select the one whose name most resembles the patient’s physical insurance card.
6. Select Save. A dialog box will appear asking for confirmation. 

Print & Mail

4. In the corresponding Payer field, type in the payer name as you want it to appear on the CMS-1500.
5. Press Tab on the keyboard. An informational box will appear. 
6. Select Save. A dialog box will appear asking for confirmation.

What if my payer ID doesn’t exist in Therabill’s database?

• Payer IDs are not universal and each clearinghouse may have a unique payer ID. The payer’s EDI department should have a list of all clearinghouses they have connections with and what payer ID they use.
• The patient’s insurance card may be old and have an outdated payer ID.
• The payer ID could be new and/or the clearinghouse did not have an electronic connection with the payer when the database was created. If you find the payer ID does exist in Availity’s Payer List, you should contact Therabill Support and request that the payer is added to the database.
• The clearinghouse does not have a connection with the payer.
1. You must map the insurance as Print Only.
   
   1. Be sure to fill out the Payor (Insurance Company) Address section when editing the client's insurance card for the address to appear in the header of the CMS-1500.

What if I find out my existing patient actually has a different payer ID?

You may experience times when you realize a client has a different insurance plan than what was originally entered into WebPT/Therabill. As previously stated, insurance mapping is hard-coded. If you change the payer ID for that patient's Note/Title (WebPT EMR insurance profile), ALL patients with that Note/Title will start to map to that newly entered payer ID. Please use the following steps to rectify the situation:

1. Delete the insurance card from the patient’s chart in both systems, the WebPT EMR and Therabill.
2. Add a new insurance card to the patient’s chart in the EMR and attach it to the case. If the insurance profile does not yet exist, create the new profile and then add the insurance card.
3. In Therabill, the new card will populate. If using an existing WebPT EMR insurance profile, then it will automatically map. If it was added in the EMR using a new profile, you will follow the mapping instructions mentioned previously.