Use this task to map Payer IDs between TriZetto and other clearinghouses. Connect's Eligibility functionality sends Eligibility requests through the TriZetto clearinghouse, so requires a TriZetto Payer ID for submission. If your organization already uses the TriZetto clearinghouse, this mapping exercise is not necessary. For users of other clearinghouses, this mapping/setup process is required in order to successfully submit Eligibility requests in Connect with TriZetto Payer IDs.
Step-By-Step Guide
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| 1 | From the Eligibility page, click Create. The Create Payer Mapping page window opens.
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| 2 | Open the Payer/Plan dropdown list and select the plan to be mapped. |
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| 3 | Enter either a TriZetto Payer ID or Name to search for the TriZetto Payer to map the payer/plan. | |||||
| 4 | Click Search. A list of TriZetto payers are displayed that meet the search criteria. |
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| 5 | Select the relevant item to map from the list of search results. | |||||
| 6 | Click Save. |
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| 7 | Repeat the steps above to add additional payer mappings. | |||||
| 8 | Click Close and close the page. |
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Eligibility / Eligibility / Configuration Tab Eligibility / Payer Mappings Tab Eligibility / Excluded Payers Payer List Tab |
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