Access Payor Management Setup from the Enterprise page. 

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Add Payor

1. Click Setup, then select Payor Management Setup, then click Payors.
   
   
    
2. Click the Add sign from the Payors screen.
   
   
    
3. Before adding a new insurance, you should always check to make sure it is not in the system.
   • Type the Insurance name in the blank field before the word find, Click find.
   • If the insurance is not in the system it will show no records to display. 
     
     
      
4. Click Add.
    
5. Fill in the boxes for Payor Information.
   
   
   • Payor- Name of the insurance (can be abbreviated.)
   • Description- Name of the insurance
   • Payor type- this controls which bill profile that payor will hit. Please contact a system representative for further questions
   • Financial Class- Select the appropriate financial class that connects this payor to the facility
   • Translation Schedule- If the service that is keyed is the service that should be billed you do not need anything in the translation schedule. Please contact a system representative for further questions
   • Diagnosis Required- If claims are to be billing to an insurance this must be checked.
   • Medicare- If the payor is Medicare it is important to have this checked.
   • Medicaid- If the payor is Medicaid it is important to have this checked.
   • Send 270- If your facility takes part of the eligibility check through Waystar for insurance this must be checked and should look like the following. Freq (In Days) determines how often eligibility needs to be ran on the payor, IEV Profile should always be Waystar 270, unless the facility has worked with Logik Solutions to setup an outside vendor/payor.
     
   • Send 837- To send your claims electronically this must be checked for the payor.
   • Follow Up Configurations- If the payor uses the default setup then nothing needs to be done.
      
6. Next fill out the information for Office Address and Contact Information which will be the billing address and phone number for the payor.
   
   
    
7. If there is more than one address, click Add Address.
   
   
    
8. Fill out the Contact Information, and add the phone number for the insurance company.
    
9. Click Save.
   
   
    
10. To locate the newly added Insurance Company, click Open Filter in the tool bar.
    
    
     
11. Type the Insurance Name in the Payor Name field, and choose Apply.
    
    
     
12. Close the box by clicking the X.
    
    
     
13. Next the user should highlight the line of the new payor and Click Payor sets.
    
    

Payor Sets

Payor sets is where the user determines which business unit(s) the Payor should be connected to.

1. Select the Payor then click Save.
   
   
    
2. The screen with the payor will show. Click Sites.
    
3. When the box opens click Add.
   
   
   
   
    
4. In the search field, type the name of the payor that the user just added, then click Find. 
    
5. Click Select on that Payor (if a second site is needed, click Add instead of Find).
   
   
    
6. Description - Type your description for the site (usually most just repeat the name of the payor)
    
7. GLMap Control - If your site uses GLMap control please populate. (this is the state that money is coming from)

   
   
   Pricing

   The last step to setting up a payor is to select the pricing.

8. Click Pricing on the payor.

   
   
    
9. Once the user has opened the Pricing box, Click Add.
   
   
    
10. Once the user clicks Add, there are two different ways to set up a rate schedule.
    • Payor pricing option one step (if you only have one rate schedule to set up)
    • Price Point - Default meaning there is only one business unit.
    • Rate Schedule - choose the rate schedule that is needed to be attached to the payor.
11. Once the user chooses the default and the rate schedule Click Save.
    
    
     
12. Payor pricing option Two Steps (if you have multiple rate schedules to be set up and/or there are multiple business units that share the same payor).
    • Price point - Price Point
    • Price Point - Choose the business unit you want the rate schedule to attached
    • Rate schedule - Choose the rate schedule to be attached to the payor
13. Once the user chooses the information Click Save. Then repeat the steps to add the other price points.