Overview
The Payer tab provides a centralized view of all payer-specific details from Admin > Payers—including credentials, documents, aging information, and instructions. Whether you’re following up on a denied claim or preparing an appeal, the most relevant data is right where you need it—no switching between portals, spreadsheets, or scattered notes.
Benefits:
- Save time by reducing repetitive research for the information you need to work your claims.
- Stay current with the latest payer requirements and key resources—without hunting through multiple tools or notes.
- Minimize missed filing or appeal deadlines.
- Maintain consistent credential and documentation management across your team.
Note: As you work your aged claims, you can update payer information directly in this tab or Admin > Payers > Payer Details. Any changes made will automatically apply to all claims for that payer.
What You’ll Find in the Payer Tab
Login Credentials
Direct access to payer login information used for portals or online systems. You’ll see:
- Credential: The name of the credential and whether it's private or shared with the practice.
- Username & Password: Your secure portal login details, complete with a hyperlink to the website. Use the copy icon to quickly copy and paste your credentials into the website as well.
- Sign On Instructions: Includes helpful login tips—like MFA requirements, authenticator app use, or where MFA codes are sent.
- Status: Indicates if the credential is Active, Inactive, or Invalid.
Payer Documents
All documents associated with the payer are stored and accessible here. You can:
- Upload new documents.
- Download existing ones.
- Remove outdated or incorrect files.
Aging Information
If aging settings are configured for the payer, OneSpot automatically calculates key deadlines, which also appear in the Dates & Deadlines section of the Claim Details header:
- Timely Filing Deadline: Calculated from the claim’s Date of Service.
- Submit Corrections By: Based on the Denied Date (for denied claims).
- Submit Appeals By: Based on the Denied Date (for denied claims).
- Expected Payment By: Also calculated from the Date of Service.
You can edit these settings by selecting Aging Settings for <Payer>. Here you can update the Aging Information Deadlines and the Aging Instructions described below.
Aging Instructions
Displays any payer-specific details you've gathered, such as guidelines for working claims, or any helpful references you may need while working claims for that payer. Centralizing these instructions and resources ensures your team can work claims consistently and efficiently, while also standardizing claim handling across your organization. This is especially valuable for payers with unique processes, requirements, or submission workflows.
Examples of information commonly stored:
- Medicare: Save links to resources like Local Coverage Determinations, Post-Op Calculators, Denial Resolution pages, or IVR conversation tools. Include notes on credentialing contacts, appeal initiation steps, and resolution processes for specific denial types.
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VSP: Store information such as provider representative contacts, how to look up a claim's status, and/or how to handle claim filing. Save links to videos explaining how to file coordination of benefit claims, determine COB processes, or how to correct claims.