Managing Payers

Manage and add payers by clicking the Payers menu on the navigation bar.

From the Payers page you can view a payer's address, policy types, and benefit plans. If needed, you can also enable/disable, and delete a payer.

To modify a payer, click the payer's name.

To add a new payer, click Add a payer.

To modify payer information, click the payer name and then the Details tab.

CSV payers file available to download

Download a csv file to view all the payers configured in your company.

The link displays on the Payers page in the upper right corner. Click the link to download the file to your PC and then open the file in your downloads folder.

The csv file will show only enabled and ZOLL payers and will include the following columns of information:

Payer Benefit plans Policy

  • Payer - Payer name

  • Payer - Benefit plan name

  • Policy - Notes

  • Payer - Site URL

  • Benefit plans - Plan name

  • Policy - Default HCPCS for mileage charges - ALS Level 1 Emergency

  • Payer - Payer site username

  • Benefit Plans - Policy type

  • Policy - Default HCPCS for mileage charges - ALS Level 1 Non-Emergency

  • Payer - Payer site password

  • Benefit plans - Notes

  • Policy - Default HCPCS for mileage charges - ALS Level 2

  • Payer - Clearinghouse claim ID

  • Benefit plans - Allowable amount effective date range

  • Policy - Default HCPCS for mileage charges - BLS Emergency

  • Payer - Clearinghouse eligibility ID

  • Benefit plans - Allowable source

  • Policy - Default HCPCS for mileage charges - BLS Non-Emergency

  • Payer - Payer ID

  • Benefit plans - Allowable calculation method

  • Policy - Default HCPCS for mileage charges - Service Car

  • Payer - Eligibility checks

 

  • Policy - Default HCPCS for mileage charges - Wheelchair Van

  • Payer - Phone number 1 and 2

    

  • Payer - Phone type 1 and 2

    

  • Payer - Notes

    

  • Payer contract - first and last name

    

  • Payer Remit IDs

    

 

Settings

  • Settings - Electronic filing indicator

  • Settings - Apply U1/U2 as first modifier for ground mileage

  • Settings - Timely filing claims

  • Settings - Apply U8 to ground mileage charge after existing modifiers

  • Settings - Timely filing appeals

  • Settings - Combine mileage charge times > 999 with same HCPCS code

  • Settings - Provider ID

  • Settings - Default claim emergency indicator to yes for emergency claims

  • Settings - Provider ID override

  • Settings - Disallow ambulance air (42) and Ground (41) for place of service

  • Settings - Clearinghouse claim ID

  • Settings - Disregard CO-45 amounts and apply to patient responsibility

  • Settings - Clearinghouse eligibility ID

  • Settings - Exclude GY modifier for non-primary payer designations

  • Settings - Carrier code

  • Settings - Import CO-45 adjustments for non-primary payer designations

  • Settings - Primary and secondary submission

  • Settings - Only output 71 characters for narrative on electronic claims

  • Settings - Mileage rounding

  • Settings - Override narrative with state, vehicle ID, and origin and destination times

  • Settings - Sequestration

  • Settings - Override narrative with TR, state, vehicle ID, and origin and destination times

  • Settings - Primary authorization requirements

  • Settings - Require referring physician

  • Settings - Apply ET modifier on emergency claims

  • Settings - Roll supplies and additional services into the base rate charge

  • Settings - Apply TN modifier to claims with rural or super-rural origin

  • Settings - Signature required for ambulance claim processing

  • Settings - Apply U1 modifier for all charges

  • Settings - ZIP code in prior auth (2300 REF)

Mult-company Management

Note: The following columns appear at the end of the file and are used only for MCM companies. Currently, you cannot download all payers from the parent company. To download, use the Context Switcher to navigate to each child company and download the CSV from that company’s Payers page.

Hint: To identify all linked payers, try sorting by alphabetical order followed by filtering by payer or company.

  • Parent company (MCM only): Displays the parent company name

  • Company name: Displays the child company name.

  • Payer linking reference ID (MCM only): This is the linking reference number. If the payer is linked, the reference ID will be the same.