Patient Demographics
Duplicate Patient Accounts
Merging accounts that both have financial transactions associated with them is a very manual process. Claims have to be voided, re-entered, and payments have to be reversed and reposted. We advise keeping the account with the oldest dates of service ...
Add New Insurance
Add New Insurance Plan First, research the payer ID numbers and payer information in Trizetto: 1. Go To the Claims Tab > EDI Portal. 2. Click on the Resources Tab. 3. Select the Payer list. 4. Now click the Blue link "Professional Payer" or ...
How can I edit a Referring Provider for the practice?
Question- How can I edit a Referring Provider for the practice? Answer- You can edit a Referring Provider using the following steps: 1. From Billing Applet click on Settings in the menu bar across the top . 2. Select Referring Providers from the ...
W/C Insurance as debtor for Pre-Auth Tab
Please follow the instructions listed below to add insurance and use as debtor in the pre-auth tab. 1. Click on Workers Compensation tab >Click the add by insurance radio button 2. Add the insurance plan informaton 3. Add Employers information 4. ...
Remove Past Due Status
To reset the aging of a patients account please follow these steps: From the patient demographics page Click on the Statements tab Check the Payment Plan "On Payment Plan" to activate and then click 'Save" Then Uncheck and remove the payment plan The ...
Referral Source
Please enter a support ticket with all the Marketing Sources you would like to see listed in the drop-down menu. After a ticket has been opened, please allow three business days for the data to be added to your account.
PT Demo Subscriber Error
The error is happening because this patient has a subscriber listed other than "Self". The system is requiring you to edit and update the "Insured Person's" information under the Insurance tab. Once you Click on the Insurance tab, go to the Insured ...
Patient Demographics Work Around
1. When in a patients demographics page 2. Click the Print Button 3. Select the Print Patient Demographics option 4. Remove all of the patient account number except for the practice prefix (First 2 letters/numbers) 5. Click the Print Button 6. Now ...
Patient Demo Changes
Starting from the billing application, go to the claim-general tab Enter the patients last name and click enter Select your patient from the list, once you have selected the patient click the (...) to the right of the last name The patients ...
Insurance Validation Ticket Response
We have validated your insurance request, please follow these steps to update your insurance list. 1. In Billing Manager, click Update Cache from the main menu 2. Click Insurances to update insurance list 3. The new plan will be listed in the ...
Patient Insurance Eligibility Verification
Real-time Verification In the Billing applet, Go to the Patients Select a Patient Go to the Insurance tab Click the Eligibility button or double-click the Insurance that you want to verify In the Scheduling applet Make a new appointment or click on ...
Error: This insurance record can not be deleted
You are receiving this error message because the system does not want you to remove an insurance plan from a patient's record when there are still open claims attached. If you have added insurance plans in error and are receiving messages that you ...
Entering a Prior-Authorization
To add a Pre-Authorization to a Patient's Demographics Details: 1. Select the Pre-Auth Tab in Patient Demographic Details 2. Select the insurance/plan in the debtor drop down from which the pre-auth was obtained 3. Enter the Provider for which the ...
Edit Insurance Plan Type
To edit Insurance Plan Types in your account's insurance plan list. 1. In Billing Manager / Pull up the patient demographics page 2. Click on the Insurance tab 3. Click on the Primary Insurance plan in the large grey box below 4. Now Click on the ...
Edit Insurance Plan Payer ID
1. Here are the steps to research payer ID numbers and payer information: Go To the Claims Tab > EDI Portal Click on the Resources Tab Select Payer list Now click the Blue link "Professional Payer" or "Institutional Payer" if applicable Scroll down ...
Delete Patient Demographics
Deleting a duplicate patient record: NOTE: Add note referencing the deleted patient account number on the account that will not be deleted for future reference. 1. Go to the Patient Demo screen for the account you want to delete. 2. On the tool bar ...
Delete Insurance Plan
If you have never used the insurance plan here are the steps to remove- From Claim General Click the plus sign as if you were to add a patient Next Click the Insurance Tab In the Plan Drop down find the plan that you want to remove. Then click the ...
Adding New Patient
You can add a patient using the following steps: When you first login to ProviderSuite and are at the Billing Tab Press the Launch Billing button Once the screen has finished launching in the upper left click on Practice Management In the drop down ...
Popular Articles
EDI Rejection: Medicare only accepts claim frequency code of 1
Medicare does not accept claims marked as corrected or voided. If you have claim rejections for "Medicare only accepts claim frequency code of 1", you will need to re-release the claim and select New, not Corrected or Voided. New should be selected ...
Strategic enrollment manager (STEM) manual and FAQs
Strategic Enrollment Manager (STEM) is a portal within Madaket Health, an enrollment partner of TriZetto Provider Solutions. This portal allows you to: Enter your administrative, practice, provider and payer information for enrollments. View ...
UB-04 facility billing Bill Type - why does it end with 7, instead of 1?
The Bill type is officially a four-digit field, but historically users have known it as a three-digit field, hence the usage of the bill type '711'. If however you print a UB-04 for a claim with a 711 bill type (a new claim), you will see it prints ...
Can a claim have multiple authorizations?
Guidelines for Item 23 ( Prior Authorization Number ) : NOTE: Item 23 can contain only one condition. Any additional conditions should be reported on a separate Form CMS-1500. This is the condition with respect to CMS-1500 guidelines, hence Item 23 ...
Posting an Unprocessed ERA
Here are the steps to Manually post an Unprocessed ERA. Watch our Training Video. From the Billing Manager > Payment Application > ERA's > Unprocessed> Refresh ERA List> Double Click on the Aetna ERA If the ERA does not need to be posted as it is a ...