Manage Lists - Payers – Healthicity Support

The Payers keep a detailed and current list of payers, which may include entities like insurance companies, healthcare reimbursement organizations, or other financial institutions that handle claims or make payments.

Follow the steps below to manage the Payers details:

Navigate to the Admin Manage Lists. The Auditees screen will be displayed.
Click on the Payers tab. A list of payers will be displayed.
User can also filter the payer based on payer, payer ID, and fee schedule.
Using the Actions menu, you can perform the following functionalities:
- Show/Hide: Toggle the visibility of specific payers in the list to streamline your view and focus on relevant entries.
- Add Fee Schedule: Add a new fee schedule to align with organizational requirements or payer-specific agreements. Follow the instructions for Add Fee Schedule.
- Add Payer: Create and manage new payer profiles, such as insurance providers or financial organizations, ensuring they are integrated into the system for claims and billing. Follow the instructions of Add Payer.
- Bulk Upload Payer: Upload multiple payer details simultaneously with a bulk upload feature, saving time and minimizing manual-entry errors. Follow the instructions of Bulk Upload Payers.
- Edit Payer: Update existing payer details to reflect changes, such as updated contact information, policy changes, or new agreements. Follow the instructions of Edit Payer.
- Delete Payer: Remove payers from the system when they are no longer relevant to ensure the list remains clean and manageable. Follow the instructions of Delete Payer.
- Link CMS Fee Schedule: Link payers to the CMS Fee Schedule to ensure compliance with Medicare and Medicaid payment guidelines and reimbursement rates. Follow the instructions of the Link CMS Fee Schedule.
- Link Custom Fee Schedule: Upload a fee schedule for multiple payers in bulk. Follow the instructions of the Link Custom Fee Schedule.
- Run Report: Generate detailed reports to analyze payer data. Follow the instructions for Run Reports.
Click Reset to clear all the defined filters.

Add Payer

You can add the new payer by following the steps below:

Navigate to the Action menu and select Add Payer. An Add Payer window will be displayed.
Enter the desired Payer Name and Payer ID in the appropriate fields.
Click Save to add a new payer.
You can also add multiple payers using the +Add More.

Bulk Upload Payers

Follow the steps below to bulk upload the payers:

Navigate to the Action menu and select Bulk Upload Payers. The Upload Bulk Payers window will be displayed.
Click on the Download Payer File to download the .csv file.

Note: Do not edit the column titles or add or remove columns. The file will not upload if any changes are made.

Fill in all the payer information in the appropriate fields.
Save the .csv file on your local machine.
Click on the Upload area, then browse and select the saved file.
Click Save to import all the payer details.

Edit Payer

Follow the steps below to edit payer information:

Select the desired payer from the list, then navigate to the Action menu and select Edit Payer. Edit the payer window will be displayed.
Edit the required information of the Payer Name or the Payer ID.
Click Save to update the changes.

Delete Payer

Follow the steps below to delete payer information:

Select the desired payer from the list, then navigate to the Action menu.
Select Delete Payer. The Delete Payer confirmation window will be displayed.
Click Submit to confirm the deletion of the selected payer.

Link CMS Fee Schedule

Follow the steps below to link the CMS Fee Schedule:

Select the desired payer from the list, then navigate to the Action menu.
Select Link CMS Fee Schedule. The Link CMS Fee Schedule window will be displayed.
Choose the desired Geographical Location and click Save. A Confirmation message will be displayed, and codes will be listed on the screen.

Note: An information pop-up will be displayed in place of the fee schedule if it's already assigned to the payer.

Click Confirm to link the CMS to the schedule.

Link Custom Fee Schedule

Follow the steps below to link the Custom Fee Schedule:

Navigate to the Action menu. and select Link Custom Fee Schedule. The Bulk Upload Fee Schedule window will be displayed.
Click on the Download Payer Fee Schedule File to download the .CSV fee schedule template and enter the required information in the appropriate fields.