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. |
| 2 | Open 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.
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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. | |
| 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. | |
| 8 | Click Close and close the page. |
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