| Carrier | The type of carrier from the following list: |
| Normal Policy Type | The type of insurance this payor normally provides to your patients from the following list: |
| COBA Identifier | The payor’s COBA (Coordination of Benefits) number. This is a unique number assigned to many insurance payors who provide Medigap coverage to their patrons and who will be automatically billed when submitting claims electronically.TIP: If the insurance payor does not provide Medigap coverage, it is not necessary to enter an COBA number. |
| Payor will deny claims submitted prior to thru date | Checked, if the payor will automatically deny claims submitted before the beginning and ending dates of service have elapsed.Unchecked, otherwise. |
| Payor requires identical HCPCS codes consolidated for the same service date | Checked, if the payor will deny claims containing two or more line items with the same HCPCS code and the same date of service (DOS).Unchecked, otherwise. |
TIP: If the payor requires some items consolidated and some items billed individually, simply separate the consolidated items with a dissimilar HCPCS code.Payor can reliably accept crossover electronic claimsChecked, if the payor gets crossover claims from a primary payor and is reliable.Unchecked, otherwise.
TIP: Some primary payors may say they crossover to a payor but then do not.Send statements to patients of this carrierChecked, if you want to send patients whose claims have this payor listed as primary a statement of account.Unchecked, otherwise.
TRAP: Only the claims that include this payor will be examined to determine whether the patient will receive a statement.Payor requires referring physicianChecked, if this payor requires a referring physician.Unchecked, otherwise.Payor requires rendering physicianChecked, if this payor requires a rendering physician.Unchecked, otherwise.Bill all chargesDefault UncheckedIf this payor requires you to bill all items on a claim including zero dollars and/or credits, then check this off.
Note: This is used primarily for Hospice.Automatically create order from recurring rentalChecked, this will allow the system to create Medical Orders from recurring orders automatically (cloud only)(*** currently unavailable)Bill claims complete, Primary must be done before billing secondary Checked, this does not allow secondaries to bill before primary is complete.
Unchecked, otherwise.
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