Topics Insurance Adjuster Master Search:  
Introduction: An Insurance Claim Adjuster investigates insurance claims to determine the extent of insuring a company's liability, typically in the case of Workers' Comp/Accident cases. They either work directly for the insurance company, or they may be freelance Adjusters hired by the insurance company to handle specific claims.

The PrognoCIS Insurance/Case Adjuster Portal is a platform that empowers the Adjuster to have a two-way communication with the Clinic. An Adjuster cannot self-register in PrognoCIS. A record must first be created by a clinic user for an Adjuster to be able to log into the PrognoCIS Insurance/Case Adjuster Portal. The Insurance Adjuster Master was created so a patient's Insurance Adjusters' details can be saved.

Field Description:

Add Icon: Click the Add icon to add a new Insurance Adjuster record.

Search Icon: Click the Search icon to invoke the Insurance Adjuster Search List from which you can select an existing Insurance Adjuster record.

Navigation Arrows: First, Previous, Next, and Last buttons act as navigation arrows and are used to navigate between Insurance Adjuster records.

Insurance Adjuster Section:

Insurance Adjuster Name: Enter the Adjuster's name. This is a mandatory field and has a limit of 50 characters.

Insurance Adjuster External ID: Enter the Adjuster's External ID. This field has a limit of 20 characters.

Insurance Company: Click the Search icon and select the Adjuster's insurance company from the Insurance Definition Search pop-up.

Insurance Company Address: The selected insurance company's address is automatically displayed here.

Insurance Adjuster Section:

Address: Enter the Adjuster's address. This is an optional field and contains two lines, i.e., Address Line 1 and Line 2. The limit for these two lines is 35 characters.

Copy Insurance Address Button: If the Adjuster and the insurance addresses are the same, then the insurance details can be automatically copied using this button. Clicking this button invokes the Copy Insurance Address pop-up, which displays the following options with their respective insurance address details:
  • Address
  • Work Tel 1
  • Work Tel 2
  • Cell Phone
  • Fax
  • Email
A checkbox is provided for each option on this pop-up and all the checkboxes are checked by default. Uncheck the checkboxes of those options whose details are not required to be copied, and then click the OK button on the pop-up. The details of only the checked options will be populated in the respective fields on the Insurance Adjuster Master. If any of the Work Tel. 1, Work Tel. 2, Cell Phone, Fax, or Email fields are blank for the selected insurance on the Insurance Master, then the respective checkbox for that option is disabled on the Copy Insurance Address pop-up (Address and Email are mandatory fields when adding a new insurance record, so they will never be disabled). The copied details are saved only if all mandatory fields are completed and the user clicks the Save button. If the user clicks the Reset button before clicking Save, then the details copied onto the Insurance Adjuster Master are cleared.

ZIP: Enter the ZIP code of the Adjuster. If the selected country is the USA and a valid ZIP code is entered, the City and State are automatically detected.

City: Enter the name of the city where the Adjuster lives.

State: Select the state where the Adjuster lives.

Country: Enter the country where the Adjuster lives. USA is selected as the default option. If the Adjuster lives outside the US, select the Non-US checkbox and enter the name of the country.

ISD Prefix: Enter the International Subscriber Dialing (ISD) Prefix of the country. This field is enabled only if the Non-US checkbox is selected.

Work Tel. 1: Enter the work telephone number of the Adjuster.

Work Tel. 2: Enter an alternate work telephone number of the Adjuster.

Note: The maximum number of characters accepted in the Work Tel. 1, Work Tel. 2, and Fax fields is 20 characters. However, this is dependent on the format set in the properties, tel.mask.applicable and tel.mask.format, which is usually 10 characters.

Cell Phone: Enter the cell phone number of the Adjuster.

Fax: Enter the fax number of the Adjuster.

Email: Enter the email address of the Adjuster. This field has a 50-character limit.

Active: When this checkbox is selected, the Adjuster becomes active and their record is available in the search list. An Adjuster will be allowed to log into the Insurance/Case Adjuster Portal only if the Adjuster's status in PrognoCIS is Active.
Note: The Active checkbox should be deselected on the Insurance Adjuster Master when the Adjuster is no longer associated with the clinic so that the Adjuster is not allowed to log into the Insurance/Case Adjuster Portal and access patient health records. Adjusters can be searched in PrognoCIS based on their status: whether it is Active or Inactive.

Last Modified by: This field displays the date and timestamp of the last modification made to the Adjuster's record, as well as who performed the modifications.

Action Buttons:

Save Button: Click this button to save a newly created adjuster record or to save changes made to an existing adjuster record. If the Insurance/Case Adjuster Portal is turned on and the user adds the Insurance Adjuster's name and email, then on clicking the Save button, the Insurance/Case Adjuster Portal login credentials are generated.

Delete Button: Click this button to delete an adjuster record from PrognoCIS; a prompt confirming the deletion is displayed.

Reset Button: Click this button to reset the recent changes made to the record before it was saved.