Entering Third Party Payer Information

If an enrolling client has proof of third party health coverage, click on the Third Party tab in the client file.

• Click on Add New Payer

The Payer Enrollment screen will appear.

• Enter the Payer from the list of regional payers in the drop down menu.

!Payers often have similar names. Make sure to compare the address on the card to the address in the drop down menu.

• Select the Payer Type from the drop down as either primary or secondary.

*The primary payer is the health insurance plan that covers the patient as an employee, subscriber or member.

*The secondary payer is the additional health insurance plan that covers the patient in addition to his or her primary plan. If the patient has a commercial plan and a Medicaid plan, Medicaid is secondary, except with MMT (Methadone Maintenance Treatment) if the patient has Medicare. In that case, Medicaid is primary since Medicare excludes coverage for MMT.

!Choosing the correct Coordination of Benefits is essential!

• Enter the Subscriber ID (sometimes referred to as the Member ID), Group #, and Effective Date from the coverage ID card.
• Click Save to save the client’s payer information.
• Coverage details, including deductibles and co-pays will be added after the client is admitted to the program.
• Insurance ID cards may be scanned by clicking on the Scan Card button.
• The next step in this process is to verify third party eligibility. Please proceed to Checking Third Party Payer Eligibility.

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