Payor Setup

When adding a new 3rd party payor to a patient's record, some fields are automatically populated: Limit Type (dollar or visits), Limit, PV Limit, Next Rollover D, etc. The defaults used to populate these fields are in Payor Setup.  Once you add a payor to a patient's file, you can still alter this to match the patient's plan, but when you don't have this information then the defaults are used.

Utilities > Payors > Payor Setup

  1. Payor - Active Payors are listed in this screen.  If you want to see inactive payors, then click on the [ALL].  The active payors are what is displayed when you click  '+Payr' to add a new payor to a patient's file.  
  2. Display As - is currently defaulted to the type, ie ExtIns, Lawyer etc... After adding in the patients insurance company, ie Alberta Blue Cross, you could change their file to display as ABC.
  3. Limit Type - represents if the plan is counted by dollars or visits, ie. MVA is most likely visits.
  4. Limit - the highest possible amount a plan will cover.
  5. PV Limit - refers to payor visit limit.  So a plan could cover $500 for chiro, but only $30 at time.
  6. Next Rollover D - this date is when the YTD Used would be reset, so whatever amount the patient has used up to that point will clear to 0.00.  The function, 'Rollover Processing' would reset this.  To learn how to handle rollover processing, click here: Rollover Processing: 3rd party Payor Accounts and/or Chart numbers
  7. Bill Difference to Patn? -  if the service is HIGHER than what the plan covers, the system will process the difference using this selection. 


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