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Insurance

The Insurance page is where you manage the list of insurance payers your company works with. Each entry connects to a payer in the national eligibility network, enabling you to run eligibility checks (270/271 transactions) and track patient coverage. Manage insurance from Settings → Insurance. Image

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Quick Start

  1. Go to Settings → Insurance in your Solum dashboard.
  2. Click “Add Insurance” to open the creation form.
  3. Search for the payer in the Eligibility Payer dropdown (e.g., “Blue Cross”).
  4. Select the payer — the insurance takes the payer’s directory name.
  5. Add other names the insurance goes by under Also known as (optional).
  6. Save — the payer is now available for patient records and eligibility checks.

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Insurance Fields

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Advanced Settings

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Adding an Insurance

Click Add Insurance to open the form. Start typing in the Eligibility Payer dropdown to search the payer directory — it includes thousands of payers across the US. When you select a payer:
  • The insurance is named after the payer’s official display name
  • The payer is linked to the eligibility network, enabling 270/271 transactions
There is no custom name. If your team knows the insurance by another label, add it under Also known as; it will show up in searches and be used when matching names on documents. An insurance cannot be saved without an Eligibility Payer, and a payer that is not in the directory cannot be added as an insurance.

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Editing an Insurance

Click the edit button on any insurance card to update its details. You can change the eligibility payer, the other names, the active status, payer ID, and additional fields. The name itself follows the selected payer.
Changing the Eligibility Payer renames the insurance to the new payer’s directory name. The previous name is kept automatically under Also known as, so records and documents that use it keep matching.

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Deactivating an Insurance

Instead of deleting, insurance entries are deactivated by toggling the Active switch off. Inactive entries:
  • Move to the Inactive Insurances section on the settings page
  • Are hidden from dropdowns when adding payors to patients
  • Can be reactivated at any time by toggling Active back on

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Network Status

Each insurance is marked as either:
  • In Network — Your company has a contract with this payer
  • Out of Network — No direct contract; different coverage rules may apply
This status is shown as a badge on insurance cards and helps your team quickly identify payer relationships.

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Where Insurance Is Used

  • Patient records — When adding a payor to a patient, you select from your company’s insurance list. Each patient can have up to four payors (Primary, Secondary, Tertiary, Quaternary).
  • Eligibility checks — The payer link determines which insurance network receives the 270/271 transaction.
  • Patient filters — Filter the patient list by insurance on the patients overview page.

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Insurance card

A patient’s policy can hold the front and the back of the insurance card as files. Each policy carries two fields, insurance_card_front_file_id and insurance_card_back_file_id, both null until a card is attached. They come back wherever a policy does: GET /v1/patient-policies, GET /v1/patient-policies/{id}, and expand[]=policies on the patient endpoints. To attach a card:
  1. Upload the file with POST /v1/files (a multipart form). Send patient_id when you know the patient. If you know which side the file shows, also send document_type set to insurance_card_front or insurance_card_back; a file you label this way is not classified again.
  2. Set the file’s ID on the policy, with POST /v1/patient-policies when you create it or PATCH /v1/patient-policies/{id} afterwards. Send null to empty a slot.
  • The same file may be both the front and the back, for one scan of both sides.
  • A file must be the patient’s (or have no patient yet, in which case it is linked to the patient), active, and a PDF or an image. Otherwise the request fails with 422, and param names the field.
  • Deleting the file, or moving it to another patient, empties the slot.
  • Solum labels the file after the slots it fills: insurance_card_front, insurance_card_back, or insurance_card when it fills both. insurance_card also stays the label of a card whose side is not known. A file that already carries another label, an intake packet for example, keeps it.
  • GET /v1/files?document_type=insurance_card is an exact match: it does not return files labelled insurance_card_front or insurance_card_back.
  • Changing a card is a change to the policy: it adds a version and is recorded in the policy’s activity.

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Locked Organizations

Some organizations have insurance management locked (typically when insurance entries are managed by Solum on your behalf). When locked:
  • You cannot add or edit insurance entries
  • An alert banner is shown on the settings page explaining the restriction
Contact support if you need changes to a locked insurance list.

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Troubleshooting