Insurance Payers
Adding Insurance Payers
To Import a Clearinghouse Payer Into the Workspace:
Go to the Insurance settings page
Under Payers panel select Add available payers
Search the payer list by payer id or name
Select one or many payers to import
Review the selected payers to import, and press Save
To Add a Manual Payer:
Go to Settings > Insurance Billing.
Click Add Payer.
Fill in the payer details in the form:
Payer ID & Payer Name: Identifies the payer (provided by the payer or clearinghouse).
Phone Number & Address: Used for claim generation and reference.
Coverage Type: Defines the type of coverage supported.
Click Create.
The payer is now available for use when creating contact insurance policies.
Billing Profiles
Billing profiles are used when creating claims and represent the billing information applied when generating claims for specific payers.
Adding Additional Billing Profiles for Individual Practitioners
Additional billing profiles can be created for individual staff members or specific payers.
To Add a New Billing Profile:
Go to Settings > Insurance.
Click + Billing Profile.
Enter the billing details for the staff member or organization.
Configure Billing Overrides:
No overrides selected: Profile is manually applied as needed.
Team Member selected: Profile is automatically applied for claims created by that team member.
Insurance Payers selected: Profile is automatically applied for claims against those payers.
Both options selected: Profile is applied only when both the payer and team member match the claim.
Updating the Default Billing Profile
The default billing profile reflects your workspace billing settings and applies when no other profiles are selected. Any updates to the default billing profile will also update your general billing settings.
To Update the Default Billing Profile:
Go to Settings > Insurance.
Click Edit next to the default billing profile.
Update the necessary fields:
Provider Type, NPI, and Taxonomy Code (primarily used for U.S. workspaces; optional for others).
Tax Number Type & Tax Number (updates billing settings).
Billing Address (updates billing address in billing settings).
Click Save.
Your default billing profile and billing settings are now updated and will apply to invoices and claims.
With these steps, you can efficiently manage insurance payers and billing profiles within your Carepatron workspace.
Our team will be able to answer any other questions you may have. Just reply via messenger through the Help channel in your workspace.