Overview
This article will instruct you on how to add a payer to your EHR.
Add an Insurance Payer
- Go to the Payers Module.
- Click Add.
- Enter the Electronic Payer ID in the Payer Type field (to search).
- Click the next arrow or hit your tab key.
- Click Choose.
- Select the correct Electronic Payer ID.
- Click Leave.
- Click on the Payer Rules tab.
- Consider if any fields need to be adjusted for this payer.
- It is common to leave most of these fields at the default for the payer. Specific fields to consider changing would be:
- Authorization required: set to Yes if all services for this payer require an authorization
- Electronic by default: set to Yes if you wish to have the Electronic option defaulted when submitting claims.
- Default Admissions facility: select if there is only one for this payer.
- Require PMAP program for each client: select Yes if this is a PMAP payer (Prepaid Medical Assistance Program)
- It is common to leave most of these fields at the default for the payer. Specific fields to consider changing would be:
- Consider how rates for this payer need to be entered using this article: Add Rates
- Consider how rates for this payer need to be entered using this article:
- Click on the Places tab.
- In this tab you can limit which place of service codes are allowed for this payer.
- In this tab you can limit which place of service codes are allowed for this payer.
- Click on the Contact Tab to enter info if applicable.
- Click Save.
Add a Generic Payer
If you want to add a generic payer, which is a payer without an electronic payer ID:
- Go to the Payers Module.
- Click Add.
- Type "generic" into the Payer type field.
- Click the next arrow or hit your tab key.
- Type in the name you want to use for the generic payer in the Payer Name field.
- Follow steps 7-13 above.