Permissions: You need the Admin permission to use these functions.
Go to Admin → Basic Setup → Payers to manage your clinic's payers. You can assign payers to a patient to record the patient's coverage information, create claims for billing, and keep track of what each payer pays on a claim.
In This Article
Add a Payer
- In the lower right, click the + Payer button.
- Fill in the payer's information.
- Click the Save Payer button.
Enroll for ERAs: If you want to receive ERAs through Fusion for a new payer, reach out to Support about enrollment.
Edit a Payer
- Click the payer you want to edit.
- Once you've made changes, click the Save Payer button.
Assign Document Names to a Payer
If a payer requires specific titles for patient documents, you can assign a default document name to that payer.
- Click the payer you want to assign document names to.
- Click the Documents tab.
- Select the document names this payer needs.
- Click the Save Payer button.
Merge Duplicate Payers
This is Permanent: Once payers have been merged, the discarded payer will be replaced on all patients who were linked to it. This action cannot be undone.
- In the lower right, click the Merge Duplicates button.
- Search for and select the payer to discard and the payer to keep.
- Click the Merge Payers button.
Delete a Payer
Restrictions: You can only delete a payer if it has not been assigned to patients and is not linked to any claims.
- To the right of the payer, click the delete icon .
- Click the Delete Payer button.
About the Fields
|Name||The payer's name, which may also be used on claims.|
|Type||When used with billing, the payer's type controls which option is selected in box 1 of the claim form.|
|Remitter||The remitter controls where a claim is sent when it is submitted electronically. If no remitter is selected, claims for this payer will be "Paper Only."|
|Calendar Year||Indicates whether or not this payer's coverage is on a calendar-year basis. This is for reference only.|
|Phone / Fax||The payer's fax number can be selected when faxing documents or invoices for a patient this payer is linked to.|
|Address||The payer's address, which may be used on claims for billing.|
Payer Specific: You can leave these blank unless this payer's requirements are different from the global reminder settings in Clinic Options.
|Co-Signing Frequency||How often users without signoff must get their daily notes co-signed for this payer.|
|Progress Note Frequency||How often this payer requires progress notes.|
|Re-Assessment Frequency||How often this payer requires re-assessments.|
|Assistants||If the primary therapist does not have signoff, this determines whether claims for this payer will bill as the assistant or the supervisor. Signoff for each therapist can be changed in Users.|
|Authorizations||Determines whether this payer's authorizations are calculated by visits or units.|
|Claims||Indicates if claims for this payer should be generated automatically when charges are submitted. If they do not generate automatically, submitted charges will be sent to the patient's billing account.|
|Accept Assignment||Indicates whether the clinic wants to accept payment on behalf of the patient. This appears in box 27 of the claim form.|
This text field can be used to store additional information about the payer for your reference.
|Daily Note Style||Determines whether daily notes for this payer will have the normal SOAP steps or will be abbreviated into a single narrative field. All the payers linked to a patient must have this set to "Abbreviated" to create abbreviated daily notes.|
|Document Names||Selecting a document name will add a custom title to documents of that type for this payer.|