This article explains how pharmacy teams add and manage a patient's medical insurance on the patient profile in MedMe. It covers adding an insurance by scanning the insurance card or entering it manually, setting the policy order, marking an insurance active or inactive, verifying eligibility, and editing or deleting an insurance.
Table of Contents
Overview
A claim can only be created for a patient who has a medical insurance on file, and the insurance that is marked as policy order 1 is selected by default when a claim is created. Keeping insurance accurate on the patient profile is the first step to getting paid.
Where to Find a Patient's Insurance
Insurance appears in two places on the patient profile:
The Insurance card on the Overview tab, where insurances are added and managed.
The Active Insurance card on the Billing tab, which shows the active insurances alongside the patient's claims.
Patients who book online can also enter their insurance during intake. Those insurances appear in the same card and should be reviewed for accuracy.
Step 1: Add an Insurance
Open the Patient Profile and locate the Insurance card.
Select + (Add insurance).
In the Add insurance modal, enter the insurance details on the right, or scan the card to prefill them (see Scanning an Insurance Card to Prefill the Details below):
Payer Name — type at least 3 characters of the payer name, or the full payer ID, and select the payer from the list.
Subscriber ID — the member ID on the card.
Subscriber First Name, Subscriber Last Name, and Subscriber Date of Birth — the person who holds the policy.
Relationship to Patient — Self, Spouse, Child, Common Law Spouse, Parent, Injured Party, or Other.
Select Add.
Please Note: By default, MedMe prefills the subscriber's first name, last name, and date of birth from the patient profile and sets Relationship to Patient to Self. If someone else holds the policy, such as a spouse or parent, update the subscriber's name and date of birth to match the card and select the correct relationship.
Scanning an Insurance Card to Prefill the Details
Instead of typing the details, MedMe can read an insurance card image and prefill the payer and subscriber fields. Scanning can be used when adding a new insurance or editing an existing one.
In the Add insurance (or Edit insurance) modal, select Add Insurance Attachment.
Choose Upload file to upload a photo or scan of the card, or Select from patient attachments to use a card the patient uploaded during booking or that was uploaded earlier.
When the upload and scanning are complete, each prefilled field shows a small sparkle icon to indicate that it has been autofilled by MedMe.
Review every prefilled field against the card and correct anything that was misread.
Select Add (or Save).
Tip: Upload both the front and the back of the card. The files also remain in the patient's Attachments card.
Warning: Insurance card scanning can make mistakes. Always confirm the payer, subscriber ID, and date of birth before saving.
Step 2: Set the Status and Default Policy Order
At the top of the insurance modal:
Status — Active or Inactive. Only active insurances can be verified or selected as the payer on a claim. Mark an insurance inactive when coverage has ended but the record should be kept for past claims.
Default Policy Order — 1, 2, 3, and so on. Order 1 is the primary insurance, 2 the secondary, 3 the tertiary. A new insurance defaults to the next free number.
The policy order is what MedMe uses to pick the default payer when a claim is created: the order 1 insurance is selected automatically. The payer can still be changed on the claim before it is submitted.
Please Note: Any number of insurances can be added to a patient. When a patient has both active and inactive insurances, a status filter (Active, Inactive, All) appears on the Insurance card.
Step 3: Verify Eligibility
Once an insurance is saved, verify that the coverage is active.
On the insurance row, select the verify button (Verify eligibility).
In the Verify Insurance modal, confirm the Date of Service. It defaults to today; shortcuts for 1 week ago and 1 month ago are available. The date must be within the last 24 months or the next 4 months.
Select Verify. MedMe checks eligibility with the payer and opens the Insurance Details modal with the Subscriber Info and Service Types tabs.
After verification the insurance row shows the Verification Request Date. A Warning or Error pill appears when the payer returned an issue; hover over it to see the error code, the recommended action, and a possible resolution. An insurance that has never been checked shows Not verified yet.
Please Note: Some payers only return eligibility to providers enrolled with them. If verification fails with a message that the provider is not on file, the pharmacy's eligibility enrolment with that payer may not be complete; check with the MedMe RCM team. See Medical Billing 101: What to Know Before Submitting Claims in MedMe.
For how to read the eligibility response, see How to Check Insurance Eligibility in MedMe.
Editing or Deleting an Insurance
To view the attached insurance card images, open the row's more menu (three dots) and select Edit. The cards appear in the attachments pane on the left of the modal. Insurance cards are also available in the Attachments section of the Overview tab.
To open the details, select anywhere on the row.
To edit, open the row's more menu (three dots) and select Edit. Change the details, status, policy order, or attachments, then select Save.
To delete, open the more menu and select Delete, then confirm.
Warning: Deleting an insurance permanently removes it from the patient's record and cannot be undone. Claims that were already submitted keep the insurance details as they were at submission time.
Troubleshooting
The payer does not appear in the search. Type at least 3 characters or enter the full payer ID. If the payer is still missing, contact the MedMe RCM team so it can be added.
Verify is disabled. Only Active insurances can be verified. Edit the insurance and set the status to Active.
The claim modal says "No insurance on file for this patient". Add at least one active insurance on the patient profile, then reopen the claim.
Conclusion
Adding a patient's medical insurance on the profile, scanning the card to prefill the details, setting the policy order, and verifying eligibility gives pharmacy teams an accurate payer to bill and lets MedMe default the primary insurance on every new claim.