Managing Payers with V1 Kipu RCM (Avea) Integration and CRM

  • Updated

Kipu EMR users who have the V1 integration with the Kipu RCM (Avea) must always create payers in the billing system 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. 

Payers for CRM

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

  1. Kipu RCM (Avea)
  2. Kipu EMR
  3. Kipu CRM

Create the Payers in the RCM (Avea)

Required Permissions:  You must have access to the RCM and a user role of Organization Practice Admin or higher to complete the following steps.

To create or add new payers in the RCM, navigate to Admin > Practice Admin, and select the Payers tab. From here, follow these instructions to Import an Electronic Payer or Create a Paper Payer.blobid0.png

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 payor 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 Payor.
    • Enter the External Payer ID:
      • AveaOffice: Use the Electronic Payer ID field from the Practice Admin > Payers section.blobid6.png
  5. Click Update to save. 

Create Payers in Kipu CRM

To add payers in Kipu CRM when integrated with a billing solution (CMD or Avea) complete the following steps. 

  1. Navigate to Admin > Payor Administration.blobid8.png
  2. Next, choose to Add Payor or Import Payors. For full instructions on adding payers, check out this guide.
    blobid9.png
    • 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.blobid10.png
  4. Next, click Payer Information.blobid11.png
  5. Click Edit information.blobid12.png
  6. Next, fill out the information with the same details entered in Kipu EMR.
    • This is what the Kipu EMR information section looks like:blobid13.png
    • This is the Kipu CRM section:
      blobid14.png

      • Short Code: The Payor Shortcode field in the EMR
      • External Payer ID: The Ext Payer Id field from the EMR (originally pulled from CMD or Avea)
      • Nickname: The Payor Synonym field.
  7. Click Save Changes.
  8. We recommend emailing CRMSupport@kipu.health when payers are added or removed to ensure that the payors are linked properly to the EMR/Billing instances. Please include the following information: 
    • Short Code 
    • Payor Synonym
    • Ext Payor Id
    • Instance URL 

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

Please use the processes described above to add a new payer into Avea and then Kipu. 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. 

 

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