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Use this task to modify the payer configuration, including the identification numbers for providers, referring physicians, facilities, and groups.
The payer configuration includes information collected on the following tabs:
Step-By-Step Guide
Step | Instructions | Additional Information |
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1 | From the Payers & Plans page, select the payer to be modified. |
2 | General Tab Click Update. The Payer: [name] page opens with the General tab displayed. Update the relevant information via the applicable steps below... |
3 | In the General section, enter the name of the payer in the Payer Name field. |
4 | Enter additional information to describe the payer in the Description field. |
5 | Open the Coverage Type drop down list and select the number format that you want to use for claim generation. |
6 | Open the Insurance Type drop down list and select the option for the type of insurance the payer provides. |
7 | In the Linked Plans section:
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8 | Click Apply. |
9 | Provider IDs Tab Click the Provider IDs tab to record the general provider identification numbers issued by the payer. |
10 | Open the Provider ID Type drop down list and select General Provider ID. |
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11 | Open the Practice drop down list and select the practice. |
12 | If adding a PAR provider:
If renewing a PAR provider:
If changing a PAR provider to non-PAR status:
If adding a non-PAR provider:
If changing a non-PAR provider to PAR status:
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13 | Select the Suspend Claims checkbox to stop generating claims for the selected provider. |
14 | Enter the contract code for the selected payer in the Contract Code field. |
15 | Repeat the above steps for each provider you want to add identification numbers. |
16 | Click Apply. |
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17 | Referring Physician IDs Tab Click the Referring Physician IDs tab to record referring physician identification numbers issued by the payer. |
18 | Select the Payer issues referring physician IDs checkbox to indicate this payer issues identification numbers to referring physicians. |
19 | Enter the identification number of the referring physician in the ID Number field of the selected provider. |
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20 | Repeat the above steps for each referring physician you want to add identification numbers. |
21 | Click Apply. |
22 | Facility IDs Tab Click the Facility IDs tab to record the general facility identification numbers issued by the payer. |
23 | Open the Facility ID Type drop down list and select General Facility ID. The table refreshes with Facility Name and ID Number. |
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24 | Enter the identification number issued to the provider by the payer in the ID Number column. |
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25 | Repeat the above steps for each facility or place of service you want to add identification numbers. |
26 | Click Apply. |
27 | Group IDs Tab Click the Group IDs tab to record or modify the general or facility-specific group identification numbers issued by the payer. |
28 | Open the Group ID Type drop down list and select General Group ID. The table refreshes with Practice Name, Physician Group, PA Group, CRNA Group, and AA Group. |
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29 | Enter the identification numbers for the following provider groups in the respective column:
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30 | Repeat the above steps for each practice or facility you want to record group provider identification numbers. |
31 | Click Save to save and close the page. |
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Payer Page / Referring Physician IDs Tab Plan Page / Referring Physician IDs Tab Plan Page / Paper Claim Options Tab Plan Page / Electronic Claim Options Tab |
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