Insurance Update Process for PTP/PTE

The insurance update ticket is sent when:

• The patient changes insurance.
• When insurance information is not correct on file, and the patient wants to bill insurance.
• When the patient has two insurance and wants to bill both

The agent must request from the patient:

• Insurance name
• Insurance member ID number
• Primary on the insurance.

Not mandatory, but try to get:

• The insurance group number
• Insurance effective date
• Insurance address/ PO Box.
• Insurance phone #

When adding or modifying insurance information in LIMS, please fill out all of the following: 

Steps to follow when submitting an Insurance Update

1. The agent will send an insurance update ticket via Syncro CRM
2. The agent will close the case in Natera Care to bill insurance
3. Add notes with the insurance information.
4. Advise the patient that will get an EOB within 30-45 business days.
5. If the patient says they will send the information via email, the agent still closes the case in Care and adds notes that the information will be sent via email.
6. The agent will advise the patient that on the email subject line should be the case number and on the body an explanation that needs insurance update and the insurance information.

Always confirm with the patient if the insurance information they provide is for Primary or Secondary Insurance.

IMPORTANT: If the patient wants to bill both insurances, please make sure to send an insurance update ticket twice (one per insurance)

When leaving notes in LIMS and/or AMD please make sure you include the notes from your Syncro CRM escalation if you submitted one:

• Insurance Name:
• Subscriber Name:
• Subscriber to Patient Relationship (Self / Dependent):
• Patient Email Address:
• Policy / Subscriber #:
• Group # (if applicable):
• Primary / Secondary:
• Medicaid (Y/N):
• Insurance Phone #:
• Claims Address (if applicable):
• AMD/LIMS Notes / Put case #:
• Agent Comments:  (Paste your notes from AMD/LIMS)

Last update by: Claudia F (August 2, 2024)