Managing Payers with Integrations (CMD/CRM)

Kipu EMR users who have integrated CollaborateMD must always create payers in the CMD billing application before adding them into the Kipu EMR. Creating the payer in the billing system generates an external payer ID that you’ll need when creating the Kipu EMR payer. This ID allows insurance to be properly mapped across systems. 

Note that payors as they appear in the CRM and payers in the EMR are the same thing. 

Finally, Kipu does not integrate directly with individual payer websites, but rather, uses clearinghouses for standard electronic transactions.

Payers for CRM

If your organization also uses the Kipu CRM, it’s important that payers are added in the following order: 

1. Billing system (CMD)
2. Kipu EMR
3. Kipu CRM

Create Payers in CollaborateMD (CMD)

Required Permissions: You must have access to CollaborateMD and have the Payer permission set to Access and Modify to complete the following steps.

To create or add new payers in CMD, navigate to Customer Setup > Payers. From here, follow these instructions to add an electronic or paper payer.

Create Payers in Kipu EMR

Required Permissions: You must be a Super Admin or have the Manage Payers permission to create/modify payers in Kipu.

Let’s review how to create payers in the Kipu EMR using the ID assigned to the payer in the billing software. 

1. Click on your initials and select Settings. 
2. Open the Payers tab.
3. Click Add item.
   
   
4. Fill out the payer information in the Add/Edit Payer window. For detailed instructions, check out this article.
   
   • Enter a Payer Shortcode that will help your facility identify the payer. For example, if the shortcodes are determined by numbers, enter the next sequential number. Otherwise, create whatever shortcode you would like. You can assign the same shortcode to multiple payers. 
   • Enter the name of the payer in the Payer Synonym field. If you use Kipu’s VOBGetter, select the payer from the Payer Search drop-down to automatically add the payer name and Kipu Insurance ID.
     • Note: You may need to re-enter the payer synonym you wish to appear in this field after you select the VOB Payer.
       
   • Enter the Ext Payer ID using the Sequence # field from the Payers section in CollaborateMD.
     
     
5. Click Update to save. 

Create Payers in Kipu CRM

Complete the following steps to add payers in Kipu CRM when integrated with CollaborateMD. 

1. Navigate to Admin > Payor Administration.
   
   
2. Next, choose to Add Payer or Import Payers. For full instructions on adding payers, check out this guide.
   
   • Add Payor: If you were not able to locate the payer you wanted in the Kipu EMR and need to create a custom payer, use this option. 
   • Import Payors: Add a payer from the Kipu EMR’s list of recognized payers (used for the VOBGetter). This option is the one chosen by most users.
3. Once the payer has been added, double-click on the payer from the list and click on the See Details button.
   
   
4. Next, click Payor Information.
   
   
5. Click Edit information.
   
   
6. Next, fill out the information with the same details entered in Kipu EMR.
   • This is what the Kipu EMR information section looks like:
     
   • This is the Kipu CRM section:
     
     • Short Code: The Payer Shortcode field in the EMR
     • External Payer ID: The Ext Payer Id field from the EMR (originally pulled from CMD)
     • Nickname: The Payer Synonym field.
7. Click Save Changes.
8. We recommend emailing [e-mail] when payers are added or removed to ensure that the payers are linked properly to the EMR/Billing instances. Please include the following information: 
   • Short Code 
   • Payer Synonym
   • Ext Payer Id
   • Instance URL 

What happens if a patient comes in with a payer that hasn’t been added to the Payers list? 

Please use the processes described above to add a new payer into CollaborateMD and then the Kipu EMR. Once the payer has been added, the admissions user can include it on the patient chart and click the Send To button from the patient’s facesheet for the applicable billing system (located under External Apps).

Note: If the claim was created, please confirm the claim has the appropriate payer and if not, update the claim to match the payer that should have been chosen. 

Kipu CRM: What if the prospect has already been sent to the EMR prior to setting up the insurance?

If you’ve already transferred the prospect to the EMR prior to creating the new payer record (as described above), please complete the following steps:

1. Update the patient facesheet in the EMR with the correct insurance. 
2. Update the prospect record in the EMR with the correct insurance for accurate reporting.