CollaborateMD: How can we bill a patient's claims for a different payer ID for the same payer?

Issue

We have a claim that needs to be sent to a different payer ID than what is currently listed for the payer for specific dates of service. Example: Claims before 10/1/2023 must be sent to one payer ID and claims after that date of service must be sent to another payer ID. 

Environment

CollaborateMD, Roles: Admin, Features: Claims and Payers.

Resolution

To submit a specific claim or claims to a certain payer ID, two separate payers will need to be created within your Customer Setup section, and then the correct payer must be manually selected on the claim(s). 

Step 1: Create the Payers

1. Select Customer Setup on the left-hand side of CollaborateMD.
2. Select Payers. 
3. Follow the process to add a New Payer to your CollaborateMD setup. See this article for instructions: Create Payers in CollaborateMD.
4. We recommend naming each payer Before [Insert date range] and After [Insert date range] with the specific payer ID for each date range that is required. Example: Payer ID 123456 is used for After 10/01/2023 and 789123 is for dates of service before 10/01/2023.
   

Step 2: Correct and Bill the Claim

Once the payers for both payer IDs with the corresponding dates of service have been created, correct the claims so that the correct payer ID appears on the appropriate dates of service. 

1. Go to the Claim tab and then select Claim again. 
2. Search for and open the claim you would like to update the payer for.
3. Scroll until you see Primary Insurance under the Claim tab.
   
4. A pop-up will appear that has the Patient Payers and All Payers tabs. Select All Payers.
   
5. Search for the payer you created in Step 1 and select it. 
   
6. The claim will automatically update the charge status to Send to Insurance with the new insurance you've selected. 
   
7. Click Save. 

Additional Information

Managing Payers with Integrations (CMD/CRM)