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.
To enable staff to add payers at the location level, navigate to System Settings > System Configuration and toggle on “Locations Can Add Payers”. Users must have either a System Admin or Location Admin role to manage Third Party Payers. If you encounter permissions errors, contact an admin in your office to adjust settings or perform the required setup.
If enabled, locations can add their own payers.
If disabled, locations must use the system-level payer database. Additionally, for users of the Cash Practice integration, ensure clerk keys are assigned to non-system user accounts in Cash Practice before proceeding with payer setup.
How to Set Up Third Party Payers
At the System Level
Go to Insurance > Insurance Settings > Third Party Payers.
Click Add System Third Party Payer.
At the Location Level
Log into the Location.
Go to 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.
Adding a New Third Party Payer
When adding a payer, you will enter the following information:
Field | Details |
Name | Full name of insurance company or attorney |
Short Name | Abbreviated name if preferred |
Payer Type | Group Health, Medicare, Medicaid, Auto, Attorney, etc. |
Contact Name | If specific contact person is available |
Phone Number/Fax | From insurance cards or when verifying benefits |
Applicable States | Defaults to All unless specified |
Address | Where claims should be sent (for paper billing) |
Office Ally/Trizetto Payer ID | Required for electronic claims submission |
Special Payer Settings
Requires Paper Billing: Some payers require claims to be mailed rather than electronically submitted.
Use Referring Provider: Required by some payers for claims submission.
Use Taxonomy Codes: Specify if the payer requires a taxonomy code attached to the claim.
Important:
The Office Ally/Trizetto Payer ID is essential for successful electronic claim submission.
Ensure you have the correct payer ID from your Clearinghouse (Office Ally or Trizetto).
Common Examples of Third Party Payers
United Healthcare
Blue Cross Blue Shield
Medicare
Medicaid
Local Law Firms handling PI cases
Worker’s Compensation Carriers
Quick Summary
Action | Where |
Add Third Party Payer | System Level or Location Level |
Required Before | Setting up policies, billing claims, posting EOBs |
Special Settings | Paper Billing, Referring Provider, Taxonomy Codes |
Critical Data | Accurate Payer Name, Address, and Clearinghouse Payer ID |
Setting up your Third Party Payers accurately ensures your insurance billing processes are smooth, compliant, and efficient across all patients and claim types.
If you need a template checklist for gathering insurance and attorney information when adding new payers, contact ChiroHD support — we would be happy to provide one!