Insurance Payers

Insurance Payers

The Payers page is where you manage the insurance providers your practice works with. Keep payer details organized and use eligibility checks to verify client coverage before appointments.

Adding a Payer

1. Navigate to Payers in the sidebar
2. Click Add Payer
3. Fill in the payer details:
   • Name -- The insurance company name (e.g., "Blue Cross Blue Shield", "Aetna")
   • Payer ID -- The electronic payer identifier used for claims
   • Group number -- Default group number if applicable
   • Contact information -- Phone, fax, and address for the payer
4. Note any payer-specific requirements (e.g., prior authorization, referral needed)
5. Click Save

Managing Your Payer List

• View all payers in a searchable list
• Edit a payer to update contact information or requirements
• Deactivate payers you no longer work with (existing claims are unaffected)
• Track which clients are associated with each payer

Eligibility Checks

Verify a client's insurance coverage in real time before their appointment:

1. Open the client's profile and navigate to the Insurance tab
2. Click Check Eligibility
3. Stillpoint sends a request to the payer via the Stedi API and returns:
   • Coverage status (active or inactive)
   • Plan details and effective dates
   • Copay and deductible information (when available)
   • Any service-specific limitations

Tips

• Run eligibility checks before first appointments to avoid billing surprises
• Keep payer contact information current for smoother claims follow-up
• Note payer-specific documentation requirements to reduce claim denials
• Eligibility check results are stored on the client profile for future reference