What to do if there is a discrepancy between the payer indicated in the 835 and the payer associated with the actual claim, or if there is a Payer ID mismatch
When opening an 835 file, users will be prompted to confirm the Payer before proceeding to automatically post the payment data. If there is a difference between the payer indicated in the 835 and the payer linked to the actual claim, or if there is a mismatch in the Payer ID, a message will appear notifying the user.
The 835-preview screen will prominently highlight the message PAYER NOT LINKED in a red cell to ensure it is easily noticeable by users.
This situation typically arises when the payer library does not contain the necessary Payer IDs.
Additionally, if there are multiple entries in the Payer Library for the same payer (to accommodate various mailing addresses, for instance), it is important to ensure that all duplicates have matching Payer IDs.
Failure to do so will result in EZClaim being unable to recognize that these payers are the same entity. In such cases, utilizing the Payment Matching Key can prove to be incredibly beneficial.
For more information, please review the Payer Library article.
Note: This situation can also occur in automatic crossover scenarios, such as when Medicare sends claims to a secondary payer that is not linked to the patient record or claims.
To address this issue, simply open the claim by double-clicking the Claim Invoice number, add the secondary payer, and then save and close the claim.
- After updating Payer IDs or adding a payer to the claim, click the
button to recheck the links
- The PAYER NOT LINKED message will disappear