How to Add an Insurance Payer, Plans and Setup CMS Defaults
2. Select a Policy Type > Select an Insurance Payer from the list > Click Add button. You can search by Name or Payer ID as well.
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3. If you need to create a custom insurance instead, select Create Custom Insurance
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4. Enter Details > Save
A Payer ID is required if the insurance is eligible for electronic submission
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Add a Plan if applicable > New Plan
- If you do not add a Plan, "None" will be the default and the Fee Schedule will be set to plan "None"
- If the payer has a different address, the Contact Info can be updated here.
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You can use the dropdown to see all plans that have been setup for that carrier and view each Plan's details under the Plan Details tab
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Enter in Information
For Box 23:
- When Box 23 is selected, an authorization number will be required on the RX Order
- The CLIA number will only drop in Box 23 for the selected CPT code.
For Box 24i:
- G2 - Provider Commercial Number
- ZZ - Provider Taxonomy (a list of valid Taxonomy codes)
For Box 32 and 33:
If an Alternate Service Facility Name or Alternate Billing Provider is entered in the CMS Defaults, that will override the Service Facility Name or Billing Provider name on the printed CMS 1500/837 EDI.