Version 20.17
 This window map article points out some of the important aspects of the window you're working with in OP but is not intended to be instructional. To learn about topics related to using this window, see the Related Articles section at the bottom of this page. |
About Insurance Payer Details
Path: Billing tab > Payers button > New or Edit button
The Insurance Payer Details window is broken up into four tabs: Basic information, Payer Coding Rules, Claims/Routing, and Contracts. These tabs house the payer information as it relates to coding rules, transmitting claims, and verifying eligibility.
Insurance Payer Details Map
Number | Section | Description |
1 | Basic Information tab | The Basic Information tab contains all the basic details for the insurance payer such as short code*, short name*, full name*, address, contact name, phone number, ext, note, status, start date, end date, and fee schedule. *= Required fields |
2 | Payer Coding Rules tab | The Payer Coding Rules tab contains the immunization administration coding rule override for the payer, special vaccine coding rules, special CPT coding rules, and special claim coding rules. |
3 | Claims/Routing tab | The Claims/Routing tab sets the insurance payer transaction details. |
4 | Contracts tab | The Contracts tab lists all the contracts associated with the insurance payer with an effective date and expiration date. You may also attach a contract. |
5 | Change/Merge Code button | The Change/Merge Code button opens the Change/Merge Codes form. This button begins the process of changing the existing insurance carrier short code to a new insurance carrier short code or merging the existing short code with a different existing short code. This operation will change the existing Carrier Code for all corresponding records in the forms. It should not be performed while the system is active. |
| 6 | Save and Cancel buttons | The Save button is used to save changes or entries made in the Insurance Payers Details window. The Cancel button is used to leave the Insurance Payer Details window without saving any changes or entries. |
Version 20.16
About Insurance Payer Details
Path: Billing tab > Payers button > New or Edit button
The Insurance Payer Details window is broken up into four tabs: Basic information, Payer Coding Rules, Claims/Routing, and Contracts. These tabs house the payer information as it relates to coding rule, transmitting claims, and verifying eligibility.
Insurance Payer Details Map
Number | Section | Description |
1 | Basic Information tab | The Basic Information tab contains all the basic details for the insurance payer such as short code, short name, full name, address, contact name, phone number, note, status, start date, end date, and fee schedule. |
2 | Payer Coding Rules tab | The Payer Coding Rules tab contains the immunization administration coding rule override for the payer, special vaccine coding rules, special CPT coding rules, and special claim coding rules. |
3 | Claims/Routing tab | The Claims/Routing tab sets the insurance payer transaction details. |
4 | Contracts tab | The Contracts tab lists all the contracts associated with the insurance payer with an effective date and expiration date. You may also attach a contract. |
5 | Change/Merge Code button | The Change/Merge Code button opens the Change/Merge Codes form. This button begins the process of changing the existing insurance carrier short code to a new insurance carrier short code or merging the existing short code with a different existing short code. This operation will change the existing Carrier Code for all corresponding records in the forms. It should not be performed while the system is active. |
| 6 | Save and Cancel buttons | The Save button is used to save changes or entries made in the Insurance Payers Details window. The Cancel button is used to leave the Insurance Payer Details window without saving any changes or entries. |
