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

Step

Instructions

Additional Information

1

From the Eligibility page, click Create. The Create Payer Mapping window opens.


The steps described here are for accessing the Create Payer Mapping window from the Eligibility page. This window can also be accessed from the Charge Batch Information / Check Eligibility: Missing Mappings tab. 


2Open the Payer/Plan dropdown list and select the plan to be mapped. 


The dropdown list will display all plans that are not already mapped and are tied to non-TriZetto clearinghouses.


Once a Payer/Plan is selected, the relevant Clearinghouse and Clearinghouse Payer ID are displayed.


3Enter either a TriZetto Payer ID or Name to search for the TriZetto Payer to map the payer/plan.


4Click Search. A list of TriZetto payers are displayed that meet the search criteria.


If the payer you are looking for is not displayed in the list, it is not a payer currently supported by TriZetto.


5

Select the relevant item to map from the list of search results.


6

Click Save.


Alternately, you can click Save & Add Next to clear the form and quickly add another mapping.


7

Repeat the steps above to add additional payer mappings.


8Click Close and close the page.







Eligibility

Eligibility / Eligibility / Configuration Tab

Eligibility / Payer Mappings Tab

Eligibility / Excluded Payers Tab



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