Add a Carrier
1
Open Insurance Carriers
Go to Settings > Billing > Insurance Carriers.
2
Start a new carrier
Click Add Carrier. A window opens with a Carrier section and a Plans section.
3
Fill in the carrier
- Name (required) — The carrier as your team refers to it, such as “GEICO”.
- Payer code — Needed for electronic eligibility checks. Leave it blank if the carrier has none.
- TSPID — Where electronic claims are routed. It says where a claim is sent rather than who the payer is, so it is usually a different number from the payer code — keep both. Leave it blank if you don’t have one.
- Payer category — Health or Property & Casualty. This decides which plan types are offered below.
- In-network — Switch on if you are contracted with this carrier.
4
Add its plans
Click Add plan for each plan you bill, then fill in:
- Plan name (required) — For example, “No-Fault PIP” or “Aetna Choice POS II”.
- Plan type — What kind of plan it is. The list is limited to the payer category you chose.
- Coverage type — Which kind of care the plan pays for: Medical, Dental, Vision, or Behavioral health. This is a separate question from plan type, because a dental PPO and a medical PPO are both PPOs. Leave it as Not set if you’re not sure.
- Claims address — Street, city, state, and ZIP. Each plan has its own, because one carrier often uses different addresses for different plans.
- Claims phone for this plan — The number to call about a claim on this plan. Each plan has its own, for the same reason the address does: plans under one carrier are often run by different companies. Leave it blank if you don’t have one.
- Notes — Billing notes about the plan, such as “Send claims on paper only”. Never patient details — every biller sees these.
- Active — On by default. Switch it off to keep a plan you no longer bill on file without offering it when staff pick a plan on a patient.
5
Save
Click Add Carrier at the bottom. The carrier and all its plans save together.
Find a Carrier
The list groups plans under the carrier that offers them. Click a carrier’s name to show or hide its plans.- Search matches the carrier name, payer code, TSPID, plan name, plan type, and claims address. Searching “London” finds every plan you mail claims to there.
- All plan types narrows the list to one kind of plan.
Complete a Claims Address
A yellow line down the left edge of a plan means its claims address is not complete. A banner at the top of the page counts how many plans still need one. A claim can’t be mailed without a street, city, state, and ZIP, so a plan with only part of an address is marked the same as one with none. Open the carrier, fill in the missing parts, and save. The mark and the banner clear on their own.Edit or Archive a Carrier
Open the menu at the right of a carrier’s row.- Edit carrier and plans reopens the same window. Removing a plan there archives it when you save.
- Archive carrier removes it from the list and from the picker staff use on patients.
Archiving never changes coverages already saved on a patient. Each one keeps the plan name, plan type, coverage type, claims address, and claims phone it was given, so a Super Bill printed months ago still shows the address it was issued with.
Use a Saved Carrier on a Patient
On the patient’s chart, open the Insurance section and click Edit, then start typing in the Insurer field. Saved plans appear as you type, each showing its plan type and claims address. Pick one and the plan name, plan type, coverage type, claims address, and claims phone fill in. A plan with no claims phone or coverage type saved leaves that field blank rather than borrowing another plan’s. Anything that fills in stays editable, so you can correct it for this patient without changing the saved plan. If the carrier isn’t saved yet, keep typing and choose the Use ”…” option to enter it by hand. The same field appears when you add insurance while building a Super Bill.Staff need the View Insurance Carriers permission to pick a saved plan, and Manage Insurance Carriers to add or edit one. See Permissions.