Guarantor Information

The Guarantor section identifies the person responsible for payment and contains the primary and secondary address information.



Data Field Information
Prompt Response Req Len
Last Name Type the guarantor's last name. 60
Suffix Type the Guarantor's suffix. It may be up to 10 characters.   10
First Name Type the guarantor's first name.   35
Middle Name Type the guarantor's middle name.   25
Address Line One This address is used for the mailing address for the patient's statement unless the 'Primary Address' field in the Billing Information screen is cleared.

If you selected '0 - Same' in the 'Rel to Guarantor' field in the Patient Name and Address Information screen, the patient's name, address, social security number, and e-mail address will default in the Guarantor Information fields. You can edit the guarantor's address if it is different from the address displayed.

If you selected '0 - Same' in the 'Rel to Guarantor' field in the Patient Name and Address Information screen and if you make changes to any of these fields on the Patient Information screen, the Guarantor Information screen will automatically be updated. If you make changes to any of these fields on the Guarantor Information screen the Patient Information screen will automatically be updated.

If you select a relationship other than 0 Same and you make changes to any of these fields in the Patient Information screen, CGM webPRACTICE will ask if the Guarantor information should be updated. If you make changes to any of these fields in the Guarantor Information screen, CGM webPRACTICE will ask if the Patient information should be updated.		   35
Address Line Two Type any additional secondary address information.   35
Zip Code Type the five digit zip code or the zip+four. If you type the zip+four, the dash is automatically inserted before the last four digits.   10
City The city automatically populates based on the Zip Code entered, or you can type the name of the city.   15
State Code The state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list.

Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. If you disagree with the converted address, you can change it back and save it without the validation changes. These changes will prevent claims from being rejected or added to the Exception report due to an invalid address or state code.

   3
County Select the county code from the County list.   5
Country Code Type the country code or select from the Country list.   2
Subdivision     3
Telephone Number Type the phone number for the guarantor.   20
Social Security # Type the guarantor's nine digit social security number with or without dashes.   11
Birth Date Type the guarantor's birth date in a MM-DD-CCYY format or click the calendar icon to select a date. The century will automatically be set to '1900' if only two digits are entered for the year and the year is later than the current year. For example, 06-25-58.   10
E-Mail Address Type the guarantor's e-mail address.   40
Secondary Address One Type any secondary address information.

For example if the patient spends six months of the year at his primary residence and six months of the year at a vacation residence, you can type the address of the vacation residence. You would then clear the Primary Address check box on the patient's Billing Information screen and the statements would then go to the patient at this vacation residence address.		   35
Two Type any additional address information.   35
Zip Code Type the five digit zip code or the zip+four for the secondary address. If you type the zip+four, the dash is automatically inserted before the last four digits.   10
City The city automatically populates based on the Zip Code entered, or you can type the name of the city for the secondary address.   15
State Code The state automatically populates based on the Zip Code entered, or you can type the state code or select from the drop-down list for the secondary address.

Click Validate Address to convert the address entered into the standard United States Postal Service format. The Address Line One will be converted; the information in Address Line Two (if standard) moves up to the end of Address Line One; the Zip Code is converted to Zip+4 and the City and State are converted based on the Zip Code. If a standard match cannot be found, messages display to explain. You can still choose to override what is converted by Validate Address by typing in any address information you choose.		   3
County Select the county code from the County list.   5
Country Code Type the country code or select from the Country list.   2
Subdivision     10
Telephone Number Type the phone number for the secondary address.   20

You can scan and save a photograph or other form of guarantor identification using the Acquire Image function in the Action Column. For instructions on scanning, see Image Scanning. You can click any image saved on the account to view it in various sizes. A new Image Viewer window appears containing the image. You can select percentages in the Zoom list to zoom in and out as needed. You can also click Print to print a copy of the image at the currently selected percentage. See the Insurance section below to see a sample of the image window.   If your practice has a current CGM webSCAN subscription, click CGM webSCAN in the Action Column to scan the guarantor's drivers license. For instructions on scanning, see Scanning with CGM webSCAN.