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Changing Payers

Use this procedure when you need to change an incorrect payer to a correct payer. This can happen, for example, when a patient changes insurance or the originally entered payer was inaccurate.

  1. Select the Payers tab, click Actions > Edit, add the Coverage End Date, and click Accept.

  2. Add the new payer/plan.

  3. Select the Authorizations tab and click Edit for the authorization that you want to change.

  4. Clear the Active box, enter the Inactive Date (same date as start date), and click Accept.

  5. Click Add and create the new authorization for the correct payer/plan.

  6. On the Authorization table, turn on Show Inactive.

  7. Click Edit for the inactive authorization.

  8. Click Move Appointments.

  9. Select all dates of service that apply, from New Authorization select the correct authorization, and click Accept.

Note

If the PDGM payer changes to another PDGM payer in the middle of episode you must discharge the patient and re-enter as a new case. Only 1 authorization per Episode is allowed.