How do I add a carrier new to us with an electronic payor id to Centricity?
I was originally told that the list is updated by Centricity annually. Is that correct? I have payers who are established with electronic claims, makes no sense to not send them electronically. Help??
You can go to the Centricity EDI website and download the EDI payer list. I just downloaded this one last week and it was as of Sept, I believe.
Anyway, find the payer you are needing to add and make note of the GE Payer ID. This will be loaded on the EDI tab in your carrier setup. There are separate tabs in this workbook, one for Claims, Remits, Eligibility, etc so make sure you are on the correct tab.
Thanks lkeith! What if it is non the list though? How do I get it on the list?
I have had to submit service requests to have GE EDI numbers generated for new carriers. It can take up to two months.
If an insurance carrier is not on the list, then they don't have a direct way to send the claim electronically. HOWEVER, you can use a generic payor ID GEC90000P until you get a direct connection. This payor ID will allow you to send the claim electronicall to the GE Centricity clearinghouse. They will route it to Emdeon and Emdeon will drop your claim to paper. There is a minimal cost per claim that get's dropped to paper. The GE EDI Payor list is updated frequently and can be found on your CEDI website in the Library. If you have a payor not listed and want to get a connection, I suggest opening a helpdesk ticket. Hope this helps!!
Oh! One thing to add, always refer to the CEDI Payor spreadsheet when adding new carriers because the spreadsheet will tell you if enrollment is required or not before you can start sending claims. It's also handy to enroll for remittance at the same time!