Adding/Modifying Patient Demographics

The Patient Demographic Screen has 6 tabs associated with it.

1. Patient Information

2. Primary Insured

3. Secondary Insured

4. Notes/Misc

5. Bill to Information

6. Custom Fields

To add or edit Patient’s, select the Patient List, then click the New or Edit button in the upper right corner of the screen.

Enter the appropriate information for each Patient.

Items in Yellow are items that will be transferred to the CMS-1500 form.  Typically, these fields need to be filled in.

CMS Form Information	Field
Name/Address/Phone	Box 2, Box 5
Birth Date / Sex	Box 3
Marital Status	Box 8
Primary Physician	Box 31**
Referring Physician	Box 17**
Facility	Box 32**
Diagnosis	Box 21**
Patient ID / Patient Chart Number	Box 26*

* You can determine what data you want to show in Box 26 by setting the option in the HCFA Settings Screen.

** These fields are not mandatory in the Patient demographic.  They can be added when a claim is created.  If the field is set in the Patient demographic, when you create a claim the fields will default to the ones defined.