Insurance Carrier Configuration

ChartLogic has added configuration options for Insurance Carriers. Under Configurations>Carriers, users can now create Insurance carrier categories by assigning a Code and Name, optionally, a Description field is also available.

Once Carrier Categories have been created, users can create individual insurance carrier profiles that allow for more details related to each carrier to be entered.

The new fields allowed for the insurance carrier are listed below:

Code – allows for a unique code of up to 20 characters.

Name – allows user to enter a Name for the new insurance carrier of up to 100 characters.

Description – allows user to enter a description for the carrier of up to 150 characters.

Category – allows user to select a category assignment for the carrier.

Payor Website – Allows user to enter a valid URL for the website to the payor of up to 140 characters.

Address:

• Address – Allows user to enter an address of up to 140 characters for the carrier’s address.
• City – Allows user to enter a city for the carrier of up to 140 characters.
• State – Allows user to select the state from a dropdown list.
• Zip – Allows a 5–9-character zip code to be entered for carrier.

 Claims Details:

• Claims Payor ID – allows user to enter a Payor ID of up to 30 characters.
• Additionally, two checkboxes are available for more customization of the carrier to indicate if a provider is required or to allow zero-dollar claims.

Transaction Entry – Allows a user to enter a copay amount for the entered carrier.

• Additionally, four checkboxes are available for more customization which include Referral required, Authorization required, No DME Charge, and Global Period

Fee schedule – allows a checkbox to be selected to automatically apply contractual adjustment.

Eligibility – Allows a user to enter an eligibility payor ID.

• Additionally, two checkboxes are available for more customization which will demand eligibility and/or allow batch eligibility.