Add Payors (RCM Integration)

This article focuses on adding payors for organizations integrated with the Kipu EMR and Kipu RCM.

Note: This process is specific to organizations integrated with Kipu RCM Billing. If you are integrated with CMD, select managing payors.

Payor Methods

There are two main ways to add a payor in the CRM: Add Payor and Import Payor.

• Import Payors: Add a payer from the standard list of payers returned by the clearinghouse. This option is the one chosen by most users.
• Add Payor: If you need to add a custom payor or paper payer, use this option.

For both options, you will also need to add the Waystar Payer ID to the CRM Payer Information. This can be found in the Practice Admin > Insurance Payers tab under the Payer ID column.

Importing a Payor

To add payors in Kipu CRM when integrated with Kipu RCM complete the following steps. Super Admin permission is required.

1. Click Admin and choose Payor Administration.
2. Next, click Import Payors.
   
3. This displays the Master Payor List. From here you can search for the payor.
4. To select a payor, select the check box in the Import column. You can select multiple payors using this process.
5. Click Import to add these payors to your Insurance list.
   
6. Next, click on the payer's row in the Tenant Payors list.
   
7. Click See details from the sidebar that opens.
8. Ensure you're on the Payer Information tab.
9. Add the Waystar Payer ID (System Admin > Payers) to the External Payer Id field and click Save Changes.
10. The payor is now available for selection on prospect records.

Adding a Payor

If the payor cannot be located on the insurance list using the Import functionality described, you can manually add the payor. This is common for paper payors.

1. Click Admin and choose Payor Administration.
2. Next, click Add Payor.
   

3. Complete the following fields: 
    

   Add the Payor Name. Add the Waystar Payer ID (System Admin > Payers) into the External Payer ID field, if present. Create an optional Nickname to make the payor easier to locate. Is Blue Cross Blue Shield: If this is a BCBS payor, select Yes. This tells the system to run it through your local BCBS. Require Permission Option: This is used to notify the user collecting the information that this payor may require the Patient to call the Insurance Company before a VOB could be completed.

4. Click Save Changes.
5. The payor is now available for selection on Prospect records.

Payors in RCM

When a new payor is added to the prospect record in the CRM, the payor information is transmitted to RCM and mapped to the RCM Payor List using the External Payer ID field.

Payor Mapping: The payor must also be present in RCM for the mapping to occur properly. Please ensure that any new payor added to the CRM is added to the RCM Payor List first under Practice Admin > Payers.