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What is a Case?

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In Practice Management system, a case is established on every patient and is necessary for every visit. A case identifies who the payer is for the patient’s visit. This enables the system to maintain a single patient record even when a patient has a situation that would require billing to more than one entity.

gr_pinScenario: Patient Andy Griffith may be coming in and seeing you as his primary physician. Andy has Blue Cross Blue Shield insurance, which pays for all of his regular day-to-day visits. So a case will be set up for Andy Griffith for Blue Cross Blue Shield.

Now supposed Andy gets a work injury, his Blue Cross Blue Shield insurance will not be the payer. He will still see you as his primary care physician, but the payments related to work injury will be billed to Workers Compensation. Workers compensation would, therefore, have to be set up as a separate independent case. Any billing and records related to that case will be submitted to Workers Compensation.

Patient Andy Griffith would, therefore, have two cases:

1. Blue Cross Blue Shield for regular day-to-day visits.
2. Workers Compensation for visits related to the work injury.

 

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