Step 1: Add the Payer & Payer ID into your list of payers
Complete this by going to Settings > Payers and clicking the + sign in the top right of the page.
Step 2: Complete Payer Configurations
You can customize how you want modifiers to be applied on a payer by payer basis. You can create a Billing Profile to set rules one-time and apply that profile to many payers. Stride provides 2 billing profiles to start:
- Medicare which includes CCI edits and GP auto-assigned, and
- GP Modifiers: includes only CP auto- assigned.
For Each billing profile and payer you need to set the following:
- 59 code pairs
- Disallowed code pairs
- Auto-applying modifiers
- Disallowed codes.
For each individual payer you can use a billing profile as a starting point and then make custom adjustments specific to that payer. Ex. select "medicare" billing profile when adding new payer Aetna, and then make adjustments to make this a specific billing profile for Aetna.
For Stride Integrated Billing Clients ONLY:
Additionally under clearing house rules, you need to link this payer to your appropriate clearing house. The easiest way to do this is to type in the payer ID into the transmission rules field, where you will be presented with a drop down of options from your clearinghouse.
Following this step, please be sure to select electronic transmission, so that claims can be processed for this new payer electronically through Stride.
Watch here:
Step 3: Add payer to Patient
Add the payer to the patient, and be sure to uncheck Manually entered. Map to payer to the case. If the patient has filled out the electronic Intake, while their information will be entered to their insurance coverage, this will NOT map to your payer list within Stride. To map to the appropriate payer, please be sure the Manually entered box is UNCHECKED, and select the appropriate payer from the drop down menu. If steps 1 & 2 have not been completed, you will NOT find the appropriate payer.
Step 4: Notify Stride
Notify Stride support team by emailing support@stridethera.com. In this email, we need the following:
- Payer Name
- Payer ID
- Chart # of a patient that this payer is being added to
Stride team will test the verification on this patient, to ensure the new payer loaded correctly to pverify. We will respond to your email once this test has been completed.
Note: You will NOT be able to utilize p verify until this step has been complete. Additionally, while most payers allow electronic verification, some payers elect to not participate and will not be able to be added to pverify.