Configure Insurance Settings
Set provider billing and organization insurance defaults.
Configure insurance settings when providers need billable status or service codes for eligibility checks.
Who does this: Clinic administrators.
Steps
Open Settings.
Open Insurance.
Select Provider Billing.
Find the provider in the Name / Credentials table.
Use Billable to mark whether the provider should be billable.
Use Edit codes to update Service Codes.
Select Organization-wide to review the requesting identity and fallback insurance details.
Choose whether eligibility inquiries are made under a clinician or the facility. For clinician inquiries, select the default provider used when a specific provider is not available. For facility inquiries, confirm the business name and the organization NPI in Settings → Organization.
Select Save changes when organization-wide details are edited.
Insurance settings use the updated provider and organization defaults.
Optional business EIN/TIN
You can save a business tax ID for eligibility inquiries to payers that require or recommend it. Confirm that the business tax ID belongs to the requesting provider or facility and that its NPI/TIN combination matches the payer's records. This is not the patient's tax ID.
Authorized administrators can enter a nine-digit EIN/TIN. The saved identifier is masked; only its last four digits are shown. Leave the replacement field blank to keep it, or use the clear control to remove it. Changing the requesting identity may require re-entering or clearing the saved identifier.
If the requesting identity changes while you are entering a tax ID, the save may be rejected. Reload insurance settings, confirm the displayed provider or facility and NPI, then re-enter the tax ID.
Enter the exact Stedi payer IDs in Payers that require this tax ID, separated by commas, after confirming each payer requires or recommends the identifier. This list does not choose the patient's insurance payer. Summit includes the saved tax ID in manual and intake checks only when that patient's selected payer is listed and the requesting NPI matches the saved mapping. A blank list sends no tax ID. Do not guess payer requirements from the insurance name or card. For a listed payer, a missing tax ID or mismatched NPI blocks submission until the configuration is corrected. Unlisted payers receive checks without the tax ID. Clearing the saved identifier also clears the payer list.
Saving a tax ID does not complete payer enrollment. Check eligibility enrollment/access separately with the payer or Stedi.
Common pitfall: Provider-level service codes can differ from organization-wide defaults.
Troubleshooting
A provider is missing. Confirm the provider is active on Team.
A service code is not listed. Search the supported service-code list. Emergency Services is 86; Health Benefit Plan Coverage is 30. Compare them using separate requests where appropriate. Unsupported custom codes are rejected by the eligibility service.
A check reports a tax-ID/NPI mismatch. Confirm the requesting identity, the NPI saved in Organization or Team settings, and the payer's enrolled NPI/TIN combination. An authorized administrator must replace or clear the saved identifier when that combination changes.
A check is active but does not show emergency benefits. Review the returned service-specific benefits and payer messages. General active coverage does not confirm emergency coverage, the provider's network participation, or payment.
Related
- Before this: Manage Team Members
- After this: Add a New Patient
- Instead: Configure AI Intake Defaults
Need help? Contact your administrator or reach out to support.