This section provides an overview of the process for adding payers in OnTarget. The payers desktop listed under the Billing section is where each agency that either authorizes your services or that pays your claims will be setup. This is a required setup in order for the services and authorizations to be entered.
To add a new payer, click the Add Payer button. Enter in a payer code. For electronic claims, this code is specific to the payer and is typically submitted on the 837. Enter in the name of the payer and the address is necessary. For paper claims that will be produced from OnTarget, the address will be printed on the invoice.
The max lines per claim field controls how many lines are submitted on each claim. The max for most payers is typically 50 lines, although it is recommended to have a lower number as a means of efficiently managing claims, especially with regards to re-billing. The choice can also be made to only have 1 line per claim which allows re-bills to occur for a single service date, thereby isolating rebills to only what was denied.
If the payer is one in which claims are submitted for payment, check the funding payer box. This payer will then be eligible for selection as a funding payer when adding in the insurance record for the client.
If the payer is one in which requests for authorization are submitted, check authorizing payer. This payer will then be eligible for selection when entering in authorizations.
If the payer grants overlapping authorizations, check the "Overlapping Authorized Services" checkbox. This is not recommended as it becomes harder to track units effectively. In most instances, the payer should end one authorization before providing a new authorization. The system will be able to accurately track unit balances when authorizations do not overlap.
The Override NU box is the means for turning off the automated workflow for note edits after billing or payroll has been generated from a note. This is very key automated functionality and ensures that notes always reconcile to billing and payroll, a key integration feature of OnTarget. It is highly recommended that this function is enabled in order to bring efficient workflows and automatic billing and payroll reconciliation. Contact the assigned Aym account analyst to discuss options with regards to overriding this feature. Until that discussion occurs, it is important to leave this box unchecked.
Save the information.
To search for entered payers, click search. The grid will populate each payer and the list can be filtered by using any of the filtering options shown below.
The list of payers can be exported to be printed or to work within any of the common file formats.
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