Member/Insured’s Full Name
What’s in the box?
This box indicates the full name of the person who holds the Insurance Policy (also known as the Insured).
This can be the patient, or it can be the patient’s Spouse, Parent, or Other. The Insured’s Last Name comes first, followed by their First Name, and Middle Initial (if applicable).
Where does this info live in Jane?
This depends on whether the patient is the Insured or not. This can be found by heading to the Patient Profile> Billing> Insurance Policies and clicking View on an existing Policy or creating a New Insurance Policy. Under the Insured’s Info heading, you can use the drop-down menu to set the Patient Relationship to Insured.
If the Patient is the Insured: set Patient Relationship to ‘Self’
If the Policy is set to Self, Jane will use the Last Name, First Name, and Middle Initial (if present) in the Patient’s Profile. To adjust the patient’s name, head to their profile and click Edit/Settings.
If the Patient is not the Insured: set Patient Relationship to the appropriate status
If the Patient Relationship to Insured is set to something other than Self, then the Name of the Insured can be added directly to the Policy, under the Insured’s Info heading.
Is this required?
In Jane, on the CMS1500, and for an EDI: the patient’s Last and First Names are required fields. The patient’s Middle Initial is optional.
What about the EDI file?
The Subscriber - whether it’s the Patient or a Spouse, Child, or Other - is sent in Loop 2000B - Subscriber.
- The Subscriber’s last name is sent in Loop 2010BA - Subscriber Info, Segment NM103
- The Subscribers’s first name is sent in Loop 2010BA - Subscriber Info, Segment NM104
- The Subscriber’s middle name (full name, not initial) if present **is sent in **Loop 2010BA - Subscriber Info), Segment NM105