Insurance Company Electronic Claims Settings

Insurance Company Electronic Claims Settings

In order to submit claims electronically to an insurance company, you must first be enrolled in electronic claims services for that insurance payor. Once enrolled, you can configure electronic claim settings for an insurance company. 

1. At the top right corner of the zHealth application window, you will see Your Name (Provider Name). Hover the cursor over your name and a drop-down menu will open.

Click on - Update Info and a new window will open.

2. On the new window, click on the last option -"Insurances" - to see the list of insurance payor names and details.

3. To find the insurance company, use the Search box at the top right corner, enter the name and click enter.

If the insurance company already exists in your insurance master list, click on the Edit icon under Actions to review and edit the insurance company information as required.

4. Select the appropriate settings for the insurance company when applicable.

a. Insurance Name: Add, edit, or verify the insurance payer name.
b. Payor Id: Add, edit, or verify the Payor ID number. (You can find the Payor ID of an Insurance Company at this link.)
c. Claim Payer Identification (CPID): For claims process only for paper claims
d. Add, edit, or verify the Claim Filing Indicator Code (It identifies whether the primary payer is Medicare or another private payer.)
e. Accept Reassignment: From the drop-down menu, select either “Provider accept assignment code” or “Assignment accepted on clinical lab services only”. You can also select ‘Not Assigned’ depending on your services.
f. Insurance company address where you will be sending the paper claims.
g. Insurance company phone number (if available)
h. Claim Submit
: Select 'EDI' from the dropdown list if this insurance company accepts paper claims.
i. Other ID - HCFA 1500 Box 24I (shaded)
j. Click the checkbox to Leave HCFA 1500 Box 32 Empty
k. Click the checkbox to Leave HCFA 1500 Box 32 Empty
l. Other ID - HCFA 1500 Box 32B
m. Billing Provider Other ID - HCFA 1500 Box 33B
n. Select the clearinghouse
o. Unique identifier (if available)

p. Review the other details for the insurance company. If everything looks fine, click "Save" at the end of the pop-up dialog box.
Note: When enabled, this option allows the submission of electronic claims for this payer.

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