Payer = Insurance Company
In Payer , you can add a New Payer to the database by clicking on this button. You may enter the payer information here first,
and then you can select the payer in both Patient or Claim.
Click the New Payer button to begin.
For the classroom experience, you can do both: create a Payer via the Electronic Link and also enter in the information manually and click the Save button.
Create a Payer to Submit Electronically.
Click the Electronic Link search icon. If you don’t click this button and choose to add in the payer manually, see the next subject on
creating a payer manually.
A window displays for you to complete filters. Follow these steps:
1. Enter in the first word of the payer Name.
2. Enter to search “From the start of the name.”
3. Verify the claim type. Professional claims are for all CMS-1500 assignments, and institutional claims are used only in
Crown Valley assignment (UB-04). For all dental ADA-J430 claims, it is best to manually enter those payers.
4. Click the Search button.
The Master Payer Search screen will display. Locate the Payer, if any, that resembles the state and name of the Payer you are
searching for. If you find the identical payer name and state, select it. If you find a payer that has the same state but the name is
not identical but close, select it anyway, and you may edit the information.
A payer agreement will display; click the I Understand button to proceed.
Once the link defaults the payer information, it is minimal but sufficient for electronic submission. However, for your grade, you must
edit both the Payer name and contact information to match the workbook
. To edit the Payer name, simply place the cursor in the
field and make the necessary changes. In this example, I will need to remove the “OF UTAH”. Next, I will need to enter in the contact
information, which includes the fields Address, City, State, and Zipcode. All other fields should remain as defaulted.
Below you can see the changes made are the Payer name and the additions of the Address, City, State and Zipcode. It now
matches the workbook
. Click the Save
button. This payer is officially added to your ClaimGear
database and is now
available when completing patient registrations.
Create a Payer Manually to Submit by Paper
If the Electronic Link was not selected and you entered the payer information manually, there are six fields to complete. When the information is complete and matches the workbook , click the Save button. This payer is officially added to your ClaimGear database and is now available when completing patient registrations.