Overview
Setting up your payers in OneSpot is a key step in ensuring smooth claims processing, accurate scrubbing, and efficient aging workflows. Follow the steps below to get your payers added, updated, mapped (if applicable), and fully configured.
Step 1: Add Payers
This step should have been completed during the initial configuration outlined in your Part 1 email. If you haven’t added your payers yet, please refer to the final step of that email to complete the setup.
If your payers have already been added, you may proceed to Step 2: Update Payers.
Step 2: Update Payers
Your onboarding specialist will email you a OneSpot Payer Data File, which includes a spreadsheet of your most active payers. This file contains important payer details such as contact information, timely filing limits, and other deadlines.
Once you receive the file:
1. Review the File
- While we've gathered a wide range of payer data from our internal billing team, some fields may be blank, particularly for local or smaller payers.
- If any important data is missing, feel free to add it directly to the file.
- Please do not add or remove columns or change the file type (XLSX), as this may prevent a successful upload.
- If you notice discrepancies, reach out to your onboarding specialist for assistance.
- To learn more about the file and what to expect, read: Update Payer Details: Understanding the Support Team Supplied Payer Data File.
2. Upload the File
- Upload the Payer Data File to OneSpot using the steps in: Update Payer Details: How To Upload the Support Team Supplied Payer Data File.
- If you encounter any errors during upload, contact us at support@onespotbilling.com for help.
Step 3: Map Your Payers (Scrubbing Module Users Only)
If you’re using the Scrubbing module, you’ll need to "map" your payers to those in OneSpot’s database to apply the correct payer-specific scrubbing rules; however, unmapped payers will still be processed using general rules that apply broadly, while mapping allows for more precise rules based on your practice’s location or the plan type.
Learn the Process:
- Getting Started with Payer Mapping: Understand what mapping is and why it matters.
- OneSpot Payer Directory: See which payers are available for mapping.
- Determining Medicare and DME Payers: Not sure which Medicare or DME payer to map your claims to? This guide helps you identify the correct payer based on your practice’s location.
Start Mapping:
- How to Map Your Payers: Step-by-step instructions for mapping your payers.
- Video: How to Map a Payer in OneSpot: Watch a real-time walkthrough of the mapping process.
- Exclude a Payer from the Scrubbing Process: Learn how to exclude payers from scrubbing with just one click.
Step 4: Add Additional Payer Information
Additional Payer Information
After uploading your data file, enrich your payer setup by adding helpful operational details:
- Payer Details - Remit Information: Add instructions for retrieving remits for this payer. If you receive remits for the payer on a payer specific portal (like Vision Service Plan or Eyemed) you can configure the payer to appear in the Posting Worklist (see Step 5 for more information).
- Payer Details - Aging Information: Store payer specific aging instructions or frequently used links, like provider portals, or payer-specific tools.
Use Tabs to Store Key Data
Credentials Tab: Store login credentials for payer portals or systems.
Documents Tab: Upload, view, and manage payer-related files like manuals or guides.
Notes Tab: Add internal notes—track timelines, issues, or important details.
History Tab: View a log of changes made to the payer profile.
Step 5: Configure Your Payer For Your Posting Worklist
Posting Worklist Setup
The Posting Worklist serves as a centralized to-do list for remits, helping your team stay organized by showing which External Systems or Payers need to be checked for remits.
- Get to Know the Posting Worklist
- How to Configure Your Posting Worklist
- Video: Setting Up Your Posting Worklist: Configuring Payers & Externals
Maintaining Your Payer Data
Your spreadsheet upload is just the beginning. As new payers are added over time, be sure to configure them with the correct contact info, deadlines, and other key data.
Best Practices for Maintenance:
- Review annually, especially when new provider manuals are released.
- Update payer info as you work claims to ensure details stay current.
- Prioritize high-volume payers to ensure your most frequently used data is always accurate.
For step-by-step instructions on editing payer details, see the Payer Details article.