What this section is for
The Patient section identifies the patient. Insurance companies use this information to match the claim to the correct member in their system, so accuracy matters.
Fields in this section
- First Name, Middle Name, Last Name - spell the name exactly as it appears on the patient's insurance card.
- Address Line 1, Address Line 2, City, State, ZIP, Country - the patient's home address.
- SSN - the patient's Social Security number, when you have it.
- DOB - the patient's birth date. One of the most common fields insurance companies check when matching a claim.
- Sex - Male, Female, or Unknown, as recorded by the insurance company. For female patients a Pregnant field appears.
- Patient Weight (lbs) - used on some ambulance claims.
- Insured Assign Benefits, Patient Signature Source, and Release of Information - the consent answers payers require. Validation will not pass with Patient Signature Source or Release of Information empty.
Why accuracy matters
Even a small mistake in the patient's name or date of birth can cause a claim to be rejected. If the insurance company cannot match the patient to a member in their system, they send the claim back.
Example
A patient's insurance card says "ROBERT A SMITH" with a birth date of 06/15/1958. Enter the name exactly that way - not "Bob Smith" or "Rob Smith." If the card says "ROBERT," use "ROBERT." If the claim came from CloudPCR, check that the crew entered it correctly and fix any errors here.
Tips
- If the patient's name on the insurance card is different from what the crew wrote on the patient care report, use what is on the insurance card. The insurance company matches against their own records.
- Check the ZIP code carefully. A transposed digit is easy to miss and can cause problems.