Add or update a payer

RXNT provides a master payer list, which pulls in a comprehensive payer list and payer profile database. This list is updated twice daily to provide you access to the latest payer information in near real-time.

Add a payer

Click the Utilities icon in the top right corner.

Click Practice Setup then Insurance Companies.  

Click + New Payer in the top right corner.

Click Select From Master Payer List.

Enter a value in any of the following fields:

• Payer Name: The payer name. For example, Aetna.
• Payer ID: The payer ID associated with the payer. Learn more about Payer IDs through the Relay Exchange clearinghouse here!

Click on the Search icon. This will retrieve the latest information for the associated payer using the Payer Finder API. 

Select a payer from the returned search results.

Click OK.

The payer data will be populated on the Payer screen.

 The following fields cannot be edited:

• Standard Payer Name(Formerly known as Trading Partner Name)
• Professional Claim(Formerly known as Payer Electronic ID (HCFA Professional))
• Professional ERA(Formerly known as RealtimeTranEID (HCFA Professional)
• Institutional Claim(Formerly known as Claim Electronic ID (UBO4 Institutional))
• Institutional ERA(Formerly known as ERA Electronic ID (UBO4 Institutional))
• Dental ClaimERA(Formerly known as  Electronic ID (Dental))
• Dental ERAClaim(Formerly known as Electronic ID (Dental))
• Eligibility(Formerly known as Eligibility EID)

Ensure that the appropriate CPIDs for the Payer are based on the Relay Exchange Claims and Remittance Payer List.

Learn more about CPIDs here!

Enter the required information and click Save. This saves the payer in our system.

Add a custom payer

Click the Custom Payer checkbox. 

Fill out the mandatory sections, the Payer Name, Claim Filing Indicator, and Type of Health Insurance. Provide any additional payer details necessary, such as Payer Address, Accept Assignment, Claim Filing Methods, and Default Fee Schedule. 

Click Save. 

Update a payer

You may have received the following message after the claim scrubbing process is complete: “The payer ID for this claim is no longer valid. Please update the payer before resending the claim electronically. Click here to update ” If so, follow the instructions below to update the payer ID.

Click here on the message. Then click Master Payer List.

Enter search criteria to find the most up-to-date payer information. Click on the Search icon and select the correct payer from the list.

Click OK.

Click Proceed to verify and update the payer information.

On the Payer screen, click Save.

Claim specific rules

Claim specific rules are used when a payer requests certain information to be included in a particular section of the claim form. These rules need to be set up for each insurance company that you want to change what is displayed on the CMS 1500 claim form. When adding or editing a payer in the Insurance Companies section of Practice Setup, claim specific rules can be created at the bottom of the screen. Click here to learn more!

Still need help? Contact us!

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