hospitalPayer Network

Manage your payer network and insurance provider configurations

The Payer Network is your directory of insurance providers (payers). From here you can accept payers you work with and configure external ID mappings.

Viewing payers

Navigate to Payers from the main menu to see all available payers in a paginated list.

Table columns

Column
Description

Payer

Provider name, alternative names, contact info (phone, fax), portal link, and external ID count

Status

Whether the payer is Accepted or Not Accepted, with a toggle to change

Actions

Configure button (for accepted payers)

Filtering

Use the filter bar to narrow results by:

  • Is Accepted — Accepted or Not Accepted

  • Has External IDs — Has External IDs or No External IDs

Sorting

Sort payers by:

  • Name (A–Z or Z–A)

  • Accepted First

  • Not Accepted First

Use the search bar to find payers by name.

Accepting and rejecting payers

Before a payer can be used for eligibility checks, prior authorizations, or treatments, it must be accepted.

Accepting a payer

Click the toggle switch next to any payer to accept it. The payer immediately becomes available for use across the platform.

Rejecting a payer

Click the toggle switch on an accepted payer to reject it. A confirmation dialog appears — type confirm to proceed.

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Configuring external IDs

External IDs map a payer to identifiers used in your other systems (e.g., EHR, billing system, clearinghouse).

  1. Click the Configure button on an accepted payer.

  2. In the configuration dialog, add one or more external IDs:

Field
Required
Description

External ID

Yes

The identifier from your external system

Label

Yes

A descriptive label (e.g., "Epic Payer ID", "Clearinghouse ID")

Description

No

Additional notes about this mapping

  1. Click Save Configuration to save all changes.

You can add multiple external IDs, edit existing ones, or delete them from this dialog.

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When you add an external ID mapping, any patient insurance plans imported with a matching source payer ID are automatically reassigned from the unknown payer to this provider.

How payers connect to other features

Feature
Relationship

Eligibility Checks

Only accepted payers appear when creating eligibility checks. The payer's clearinghouse mapping is used to verify coverage in real time.

Prior Authorizations

Payer contact methods are used when submitting prior authorizations.

Treatments

Patient insurance plans (linked to payers) are associated with treatments for billing and workflow purposes.

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