Some payers do not accept claims electronically and require them to be printed and mailed. To accommodate this, Paper Payers can be added to the RCM. Claims created with a paper payer are referred to as Paper Claims in the RCM. These claims are printed and sent by the clearinghouse within 72 business hours of submission.
User Permissions
Only admin-level user profiles can create and manage paper payers in the RCM. For additional information on user profiles, click here.
Create Paper Payers
Paper Payers can be created in three areas in the RCM. Additionally, electronic payers can be utilized as paper payers by including the payer's mailing address and converting the claim to paper. Let's review the three areas of the RCM where a paper payer can be created!
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- Navigate to the Practice Admin > Insurance Payer section.
- Click Create Paper Insurance Payer.
- Input the payer's Name (this is who the claim will be addressed to).
- When applicable, include the:
- Paper Payer ID - this field cannot be edited after creation (at this time.)
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Payer Assigned ID - this field requires a claim form rule to be created to include the ID.
- Click Allow Multi-Year Claims to allow dates of service that span more than one year on the same claim.
- When applicable, update the Parent Payer dropdown.
- Add the following information:
- Address: This should be the mailing address, including any P.O. box, suite number, unit number, etc.
- City and State: This should be the city and state of the payer's physical mailing address.
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Zip Code: We recommend using the full 9-digit zipcode when applicable.
- Disregard the additional dropdowns and include the Claim Filing Indicator when appropriate.
- Finally, click Add Paper Payer to complete the process.
- Navigate to the Practice Admin > Insurance Payer section.
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- To add a paper payer while creating a new patient profile, add the Effective Date and click New Paper.
- Use the steps outlined on how to create a paper payer within the Practice Admin.
- Once you have entered the required fields, click Save and Add Policy Info to complete adding the paper payer.
- To add a paper payer while creating a new patient profile, add the Effective Date and click New Paper.
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- Navigate to the Treatment Episode > Intake > Insurance section of the patient's profile.
- Click Create Insurance Set.
- Input the Effective Date and click Create.
- Next, click Create under the Primary column of the Insurance subtab.
- In the Primary Payer window, click Add New Payer. Note that this process can also be used for secondary and tertiary insurance.
- Click Add Payer for Paper Claims.
- Complete the process by following the steps for creating a paper payer under the Practice Admin section of the RCM.
- Navigate to the Treatment Episode > Intake > Insurance section of the patient's profile.
Manage Paper Payers
Let's review how to manage paper payers!
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- Navigate to the Practice Admin > Insurance Payers section of the RCM.
- Click the payer name to open their profile.
- To update the payer profile for all claims billed, click Baseline.
- To update the payer profile for claims as of a specific date, click Create Scheduled Change Set.
- Add the Effective Date and click Save.
- Next, click the edit icon.
- Update the desired fields and click Save to complete the process.
- Navigate to the Practice Admin > Insurance Payers section of the RCM.
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- Navigate to the Practice Admin > Insurance Payers section of the RCM.
- Click the payer name to open their profile.
- To update the payer profile for all claims billed, click Baseline.
- To update the payer profile for claims as of a specific date, click Create Scheduled Change Set.
- Add the Effective Date and click Save.
- Next, click the edit icon.
- Update the desired fields and click Save to complete the process.
- Navigate to the Practice Admin > Insurance Payers section of the RCM.
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- Navigate to the Practice Admin > Insurance Payers section of the RCM.
- Click the payer name to open their profile.
- To convert the paper payer for all claims billed, click Convert under the Baseline column.
- To convert the paper payer profile for claims as of a specific date, click Create Scheduled Change Set.
- Add the Effective Date and click Save.
- Next, click Convert.
- Locate the payer in the Clearinghouse Payer dropdown and click Convert to complete the process.
- Navigate to the Practice Admin > Insurance Payers section of the RCM.
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