Insurance providers
Maintain insurance provider names, codes, contacts, default coverage percentage, active state, and order-form availability.
What insurance providers control
Insurance provider records define the payers or coverage programs that can be selected when handling insured patients. Each provider has a name, code, contact phone, contact email, default coverage percentage, and active status.
The resource is hidden from primary navigation, but it still supports order and coverage workflows where insurance data is needed. Access is controlled by CRM insurance permissions.
Provider information
The provider information section contains name, code, contact phone, and contact email. Name is required. Code is optional but helpful for internal finance references, claim forms, or agreements. Contact information helps reception and finance staff confirm eligibility, approvals, or claim issues.
Use consistent provider naming. If the same insurer appears under several spellings, reception may select the wrong record and finance reports become harder to reconcile.
Coverage settings
Default coverage percentage is a number between 0 and 100. It represents the default share covered by that provider. This is a default setting, not a replacement for contract rules, special price lists, approvals, or patient-specific exceptions.
The active toggle controls order-form availability. Inactive providers should not appear in new order forms, but their old records can remain for history.
Table and filters
The table shows name, code, contact phone, contact email, coverage percentage, active status, and creation time. Code appears as a badge. The active filter helps staff separate current providers from inactive or old agreements.
Use this table when onboarding a new insurer, changing default coverage, or investigating why a provider is not available during order creation.
Operational guidance
Before using a provider in daily work, confirm the coverage percentage with finance or the contract owner. If coverage varies by patient plan or test type, document those rules in the relevant pricing or contract workflow rather than relying only on the provider default.
If a provider stops working with the lab, make it inactive instead of deleting it. Historical invoices and order records may still need to show which provider was used.
Checklist
- Provider name is clear and not duplicated.
- Provider code matches finance or agreement references when available.
- Contact phone and email are usable.
- Default coverage percentage is approved.
- Inactive providers are hidden from new orders.
- Finance reviews provider changes before they affect billing.