Path: Maintenance and Setup > Insurance > Insurance
About
When your Agency goes live, there is a set of payers already imported into the software. However, if your Agency starts accepting new insurance, you will need to add the Insurance Payer into NSS Billing.
Add a New Insurance Payer
- Navigate to the Master Insurance List by following the path above.
Note: Open two instances of the Master Insurance List to allow for copying information from an existing Payer. Select a plan similar to the insurance payer you are going to add and click the Ok button to open the Master Insurance Form for the Payer. |
- Click the Ok button.
- Click the Add button. The Master Insurance Form is displayed.
- Complete the following fields on Page 1:
- Insurance ID: This must be a unique code that helps you identify the payer.
- Party Type: Select the Party Type the Insurance Payer belongs to.
- Format Type/Format Type 2: Select the claim Format Type for the payer. The most commonly used Format Types are listed in the grid below.
| Party Type | Paper Claim Format | Electronic Claim Format |
| Other Insurance | 8: HCFA 1500 - OTHER | 21: HIPAA 837 Other Insurance |
| BCBS | 2: HCFA 1500 - BCBS | 19: HIPAA 837 BCBS |
| Medicaid | 7: HCFA 1500 - Medicaid CW | 16: HIPAA 837 Medicaid Children's Waiver |
| Medicare | 9: HCFA 1500 - MC B Form | 20: HIPAA 837 Medicare B |
Note: If you need to print institutional claims, the paper claim Format Types are: 40- UB04 Medicaid, 41- UB04 BCBS, 42- UB04 Other, and 43- UB04 Medicare. |
- Insurance Name and Address: Enter the name of the Insurance Payer and address details.
- Complete the rest of the fields on Page 1 as necessary for the particular payer you are adding.
| > | Note: If the Payer should not kick a balance down to a client (Private Pay), select the Don't Kickdown checkbox. |
- Click the Page 2 tab and complete the fields. If you have a similar Payer open, copy the information and settings from the existing Payer. Do not copy the Payer ID and Payer Name fields as these should be different.
Note: You can check what information should be entered against your Clearinghouse Companion Guide. |
- (Optional) Click the Page 3 tab and complete the fields. Add override information if the insurance always needs to render under a specific Provider.
- (Optional) Click the Display Provider Info in 837 2300 NTE checkbox to add the Provider and Provider NPI from the Staff ID field on the Line Item Form to the 2300 loop NTE and Line Item 19.
- (Optional) Click the Include 837 CN1 Segment checkbox to add the Contract Number from the Program associated with the service into the CN1 segment.
- (Optional) Click the Include Agency Info in Loop 2310C on 837 checkbox to add the Agency Information from the from the Master Agency Form.
- Click the Save button.