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Member Information Required for Claim

Discover essential member information needed to streamline your claim process.

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Table of Contents

Step 1 – Add required member information Step 2 – Verify insurance coverage

This article explains the mandatory member information required to generate a claim in Pear Suite and outlines the process for verifying insurance coverage. Ensuring these details are accurately documented on the member's profile prevents processing delays and ensures billable activities are ready for reimbursement.

Step 1 – Add required member information

  1. Navigate to the member's profile and ensure the following fields are completed:
    • First Name
    • Last Name
    • Phone Number
    • Date of Birth
    • Sex
    • Address
    • Insurance company
    • Subscriber ID or CIN

Step 2 – Verify insurance coverage

  1. Locate the Insurance section at the top of the member's profile
  2. Click the ? icon to initiate a coverage check
  3. Click Get Details in the Coverage Details pop-up
    • Note: It usually takes 5-10 seconds to fetch the information from the clearinghouse
  4. Review the returned details to see the member's current insurance status and the start and end dates for their coverage

 

member data claim details

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Related Articles

  • Configuring Organization's Claims Settings
  • Searching for a Claim
  • Generating A Claim
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