Add Insurance from the RXNT Master List.
The Insurance Companies section is for the payer set-up or the entity, other than the patient, responsible for financing or reimbursement for the cost of the services rendered.
Payers must be set up so that claims can be sent and payment can be rendered. To set up a Payer, click Utilities in the top right corner.
Under Practice Setup and Insurance Companies.
By selecting New Payer, you are able to allocate the payer or person/entity responsible for the payment of the claim. Select Payer from the RXNT Master List, which contains information for over 3,000 payers.
New Payer Setup
- Select the payers’ name
- Payer Electronic ID automatically populate
- Primary payer's claims will remain electronic, while claims from smaller companies and Worker’s Comp will be printed
- The secondary claim is typically printed for a hard copy of the HCFA1500
- The claims indicator is Commercial unless Medicare, Veterans, and other exclusions
- apply
- The type of insurance must be from the drop-down menu
- The default fee schedule is what the practice has set up for the practice
- Claims-specific rules that apply to the payer when creating the EDI or the HCFA1500 form can be added.
- Currently, there are six rules listed, but if more are identified, they can be added in less than a week. Please contact RxNT support at 800-943-7968 to request a rule to be added.
Add Custom Payer
By selecting New Payer, you are able to allocate the payer or person/entity responsible for the payment of the claim.
Next, select the Custom Payer checkbox and complete the necessary fields.
Set Claim Specific Rules- CMS 1500 Form
Note: These rules need to get set up for each insurance company that you want to change what is displaying from the drop-down on the CMS 1500 form for each selected payer.
Under Practice Setup and Insurance Companies.
The image below is from inside a payer profile. Navigate down to the Claim Specific Rule and select the green +.
Here, click the Select v drop-down, and a display of Claim specific rules is shown.
Display CLIA on Box 19
Practice Setup and Insurance Companies.
In the drop-down, select display CLIA on Box 19 and save.
Next, go into Service Facility Location
Add the CLIA #
Lastly, go into Procedure Codes and make sure the procedure code is set as a CLIA Lab Procedure.
Once all those things are done in your encounter, make sure you are billing a payer that has the claim-specific rule you set up at the Service facility location, where you populated the correct information, and you linked the correct procedure code, and that will update the populated information for you on box 19.
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