[Navigation] Patient > Patient Contacts - Appointment > Appointment Details > Payor Details > Coverage Type
[Accordion] Overview
The Coverage Type controls how selected insurance payors participate in the billing process for an appointment. It allows you to designate a payor as Primary, Secondary, or Tertiary, direct how balances transition between payors, or exclude specific insurances from claim processing entirely.
[Accordion] Getting Started
The Coverage Type sets the billing order for insurance payors (Primary, Secondary, Tertiary) and determines how balances are routed or excluded.
Coverage Type:
Covered: The selected payor is attached to the claim and billed for the calculated balance
Non-Covered: The selected payor remains attached to the claim, but any remaining balance automatically passes to the next payor in sequence
Bypass: The selected payor is completely excluded from the claim and skipped during processing
Assign Coverage Types to manage multi-insurance billing in a more flexible manner. Additionally, each payor record includes dedicated Authorization Number and Authorization Revision Number fields, ensuring authorization details automatically flow directly onto the generated claim.
[Note] These authorization details automatically appear in BillingTracker’s Claim Detail form, eliminating manual updates before submitting Secondary or Tertiary claims. [BillingTracker > Billing Account > Claim Details > Claim-Specific Insurance Information]
[Accordion] FAQs
[Q] Can you give me use cases for this feature?
[A] Some organizations need to handle situations in which patients may not have their services covered by a payor based on their insurance authorization. The Primary Payor needs to then be bypassed, and the claim submitted directly to the Secondary Payor as if the Primary Payor did not exist. There can be other scenarios in which the Primary Payor needs to be associated with the claim (for COB purposes), but will not cover the cost, so the organization needs to directly submit to the Secondary Payor. The Coverage Type will allow you to handle both situations.
[Q] Why can't I select a Tertiary Payor when the Secondary Payor is blank?
[A] The system requires sequential payors to be selected. If skipping a Secondary Payor, assign the Tertiary insurance to the Secondary Payor position and set its Coverage Type to maintain your desired billing behavior and allow the appointment to save.
[Q] How do authorization details work with Coverage Type?
[A] Each payor tier (Primary, Secondary, Tertiary) includes its own Authorization Number and Revision Number fields. Non-Primary authorizations also automatically map directly to generated claims and populate in BillingTracker’s Claim Detail view, removing the need for manual edits before Secondary or Tertiary submission.
[Accordion] Related Articles
Patient Contacts - Appointment