I have a patient with an insurance company that is not listed in Therabill's payer list. How can we get a new insurance company listed?
Adding a new insurance company to the insurance company list (and having it available for electronic claims) can only be done if:
- the insurance company has an EDI payer ID
- the insurance company is listed in one of the clearinghouses that Therabill has a partnership with.
If you have a new insurance company and you can not find them in our insurance company list. Here are the steps you should take.
- Trying changing your search term in Therabill. Try typing in the insurance company name in a different way. For example, instead of typing UHC (for United Healthcare), try typing in "United Healthcare".
- Call the insurance company and ask them for their EDI Payer ID. You may be able to find the EDI Payer ID on the insurance card, but if it is not there, you will need to call the insurance company. Once you have the EDI Payer ID, you can search Therabill's insurance list (on the add/edit insurance card form) by typing in the EDI Payer ID that you received from the insurance company.
- If you can't find the insurance company in Therabill by the EDI Payer ID, then send an e-mail to firstname.lastname@example.org with the Insurance company name and EDI Payer ID. Therabill will then search through the clearinghouses that Therabill has a partnership with to determine if they can be added to our list.
- Availity: http://availity.com/documents/edi%20guide/availity_edi_clearinghouse_health_plans_list.pdf
- Office Ally: http://officeally.com/resourcecenter.aspx?id=73
If the insurance company cannot be added to our insurance company list
It may turn out that the insurance company you are looking for cannot be added to our list at this time (they can't be found in either of our clearinghouses). If this is the case, then you will need to submit by paper to them. If this is the case, you can create your own "Print Only" insurance company in Therabill by typing their name into the insurance company text box on the add / edit insurance card form. You may want to check back at a later date, as new insurance companies do get added to the clearinghouses pretty regularly.
Can I submit through my own clearinghouse account?
If you have your own clearinghouse account and your clearinghouse has the payer in their list, usually, Therabill cannot connect to your clearinghouse account. You will want to verify with your clearinghouse that they allow software vendors to submit 837 files to your account using secure FTP (sFTP) or FTP with PGP encryption. If they do, ask them for a contact person that Therabill can call to get the connection information to both send and receive files.