---
title: "Record how a patient's visits are paid for"
summary: "Add a patient's medical insurance or payment method on the Billing & insurance tab, and check the cover with the insurer before you send a claim."
source: https://practor.app/en-za/help/patients-and-records/record-how-a-patient-pays
published: 2026-09-21T06:40:05.501Z
updated: 2026-09-29T07:14:52.526Z
category: "Patients and records"
---

Every patient needs a cover on their record, including the ones who pay you directly. Practor won't let you invoice a patient who doesn't have one: **Cannot create invoice - patient profile incomplete. Missing: billing information.** Their record also shows a **Profile incomplete** banner. It lists what's missing.

## Open a patient's cover

1. Go to **Patients** and open the patient.
2. Press the **Details** tab.
3. Choose **Billing & insurance** in the sidebar.

**Coverage methods** lists what's on file. An insurance cover shows the scheme's name. Someone who pays for themselves shows as **Self-funded**, with the payment method underneath.

Rows stay in the order you added them. **Primary** on the top row just means it was added first, and there's no way to reorder them. When you send a claim, Practor picks the first insurance cover for you. That isn't always the one marked **Primary**, and you can change it on the claim.

## Add a cover

Press **Add**, then choose **Self payment** or **Insurance** under **Coverage type**.

**Self payment** asks one more question. Pick a **Payment method**: Cash, Card, Bank transfer, Debit order or Cheque.

**Insurance** asks five.

| Field | What it takes |
| --- | --- |
| Insurance provider | The scheme. Pick it first: the plan list comes from it |
| Insurance plan | Stays greyed out until you've picked a provider |
| Member/Policy number | The number on the patient's insurance card |
| Plan owner | Who the policy belongs to. Self, Spouse, Child, Parent, Common law spouse, Other or Injured |
| Dependent code | 00 for the main member |

If the patient has an identity number on their record, a button appears beside the member number and copies it in. Some schemes use it as the membership number.

**Verify eligibility** is at the bottom of the insurance form and starts switched on, so Practor sends the check as soon as you save. You only see it if your practice can run checks.

Press **Add coverage** to save.

![The Add coverage dialog with Insurance chosen](https://res.cloudinary.com/drmnydbcs/image/upload/c_limit,w_1600/f_auto,q_auto:good/v1/help/coverage/add-insurance.png?_a=BAMAOGDh0#672x868 "Choosing Insurance opens the five fields under it. Self payment asks for a payment method instead.")

## Check a cover with the insurer

Open the row's actions menu and press **Verify cover**. The **Insurance verification** card below the list does the same thing. It has a **Verify** button for each cover, and it appears as soon as the patient has any insurance on file.

![The actions menu on a cover](https://res.cloudinary.com/drmnydbcs/image/upload/c_limit,w_1600/f_auto,q_auto:good/v1/help/coverage/row-actions.png?_a=BAMAOGDh0#144x147 "The button at the end of a row. Look up family and Verify cover are only here once the practice is enrolled.")

The check runs in the background and the badge changes on its own.

| Badge | What it means |
| --- | --- |
| Verifying | The request is with the insurer |
| Verified | The insurer confirmed the member. The card below reads **Eligible** |
| Not eligible | The insurer didn't confirm them |
| Error | Practor couldn't finish the check. The reason is on the card |

An eligible cover can still show **Warnings** underneath it. A refused one shows **Rejection details**, the insurer's own list of codes. Practor doesn't save those codes. Write down what you need before you leave the page. Come back and the card still has the insurer's reason, but the list is gone.

A cover goes back to unverified when you change the insurer, the plan, the member number or the dependent code, because the insurer's answer was about the old details. Check it again.

You're only charged for a check when the insurer confirms the member, so a refusal costs you nothing. The family lookup below is charged the same way. [What Practor costs](/help/account-and-billing/what-practor-costs) has the rates.

## See everyone on the same membership

Press **Look up family** in the row's actions menu. It's greyed out until the cover has both a member number and a plan.

**Family on this plan** checks what it needs before it sends anything. It either says **Ready to look up**, or counts what's missing and lists it. Fix those, then open the dialog again.

Press **Look up family** to run it. The result lists everyone registered under that membership with their dependent code, and marks which one is this patient.

![The family lookup, ready to run](https://res.cloudinary.com/drmnydbcs/image/upload/c_limit,w_1600/f_auto,q_auto:good/v1/help/coverage/family-lookup.png?_a=BAMAOGDh0#672x368 "The member number and plan it will send are right there on the panel.")

| If it comes back refused | What it means |
| --- | --- |
| We couldn't find this patient on the plan | The member number or the date of birth doesn't match the scheme's record |
| This member is currently suspended | The scheme won't answer while the membership is suspended |
| Couldn't reach the insurance | The scheme's service is unreachable. Try again shortly |
| The lookup didn't go through | Anything else |

Practor picks that heading from what the insurer sent back, and shows their own wording underneath.

## Turn the checks on

Enrol the practice for insurance claims, and put a practice number on its billing profile. Neither check runs without both. Until then **Verify cover** and **Look up family** aren't in the menu, and the **Insurance verification** card shows a panel instead of the buttons.

| What the panel says | What to do |
| --- | --- |
| Not enrolled for insurance claims | Press **Enrol for insurance claims** |
| Billing profile required | Press **Configure**, then fill in your practice number |

[Submit a claim to a medical insurer](/help/billing-and-claims/submit-an-insurance-claim) covers enrolment and the rest of those panels.

## Change or remove a cover

Open the row's actions menu and press **Edit** or **Remove**. Removing asks you to confirm, and it can't be undone.

## Related

- [Add a patient](/help/patients-and-records/add-a-patient)
- [Submit a claim to a medical insurer](/help/billing-and-claims/submit-an-insurance-claim)
- [Create and send an invoice](/help/billing-and-claims/create-and-send-an-invoice)