In ChiroHD, Third Party Payers refer to any entity responsible for a claim that is not the patient. This includes:
Health Insurance Companies
PI (Personal Injury) Insurance Carriers
Worker's Compensation Carriers
Attorneys managing PI or WC claims
It’s important to understand that Third Party Payers is a broad term covering all external claim responsibilities.
Where Third Party Payers Can Be Managed
You can set up Third Party Payers at:
System Level (for all locations)
Location Level (specific to individual offices)
Important: Some franchise networks may restrict adding Third Party Payers at the location level through System Settings, System Configuration, Locations Can Add Payers. Please see our other resources on this feature here.
How to Set Up Third Party Payers
At the System Level
Go to your System Dashboard, Insurance, Insurance/Third Party Payers.
Click Create System Payer.
At the Location Level
Log into your Live Location, Insurance, Insurance Settings, Third Party Payers.
You will see both:
System Payers (shared across locations)
Location Payers (specific to your location)
Note:
If your system restricts location payers, only the System Payers column will appear.
Why Setting Up Third Party Payers is Critical
You must set up the Third Party Payer first before you can:
Set up a patient’s insurance policy.
Bill insurance claims.
Post EOBs (Explanations of Benefits).
Run insurance-related reports.
If the payer is not set up, you will not find it in the dropdown list when setting up insurance coverage for a patient.
Common Examples of Third Party Payers
United Healthcare
Blue Cross Blue Shield
Medicare
Medicaid
Local Law Firms handling PI cases
Worker’s Compensation Carriers
Adding a New Third Party Payer
When adding a payer, you will enter the following information:
Name – Full name of insurance company or attorney.
Short Name – Abbreviated name if preferred.
Payer Group -
Payer Type – Group Health, Medicare, Medicaid, Auto, Attorney, etc.
Clearinghouse Payer ID - Required for electronic claims submission.
Ensure you have the correct payer ID from your Clearinghouse.Contact Name – Specific contact person, if available.
Phone Number/Fax – From insurance cards or obtained during benefits verification.
Specific to (State) – Defaults to "All" unless otherwise specified.
Address/City/State/Zip – Mailing address where claims should be sent for paper billing.
Paper Billed - Some payers require claims to be mailed rather than electronically submitted.
Single Day Bills - this feature is now standard and no need to check to single day bill
Force Render Box 32 - ChiroHD’s integration with clearinghouses follows a format where Box 32 is left blank if the information in Box 32 and Box 33 is the same. This was specifically requested by the clearinghouses. While this is the recommended format for most clearinghouses, some payers may require Box 32 to always be filled out, leading to claim denials if not. Once the Force Render Box 32 option is checked for a payer, all future claims submitted to that payer will include the required information in Box 32.
Requires Referring Provider - Required by some payers for claims submission.
Uses Provider and NPI2 Taxonomy Codes - Specify if the payer requires a taxonomy code attached to the claim.
Important Reminders
If your office handles multiple divisions or addresses for a single insurance brand (like Blue Cross), you need to create separate payers for each address or division.
Accurate setup ensures:
Claims are billed correctly.
EOBs are posted accurately.
Reports pull the correct payer data.
Tip: If you are trying to set up a patient’s policy and cannot find the correct payer, always check first if the third party payer has been created in the system.
Why Setting Up Payers Properly Matters
Setting up third party payers correctly at the beginning saves significant time later:
It avoids billing delays.
It ensures claims route correctly to clearinghouses and payers.
It maintains clean insurance reporting.
It simplifies EOB posting and payment reconciliation.
Setting up your Third Party Payers accurately ensures your insurance billing processes are smooth, compliant, and efficient across all patients and claim types.