Network Status Overview

This guide explains how to configure the Network Status feature, including how to add payers to the Payer List and display their network status directly in the Screener tab.

Setting up the Payer List

Step 1: Complete the Payer List

1. Access the Payer List

   1. Go to Admin Hub > Screener Settings > Payer List

2. Add or Manage Payers

   1. Click Manage Payers in the top right corner

   2. To add a new payer:

      • Scroll to the bottom

      • Click Add Payer

   3. Select or search a payer from the dropdown list (~500 options available)

   4. Once your payers have been added, select Save Changes to update the grid

Step 2: Configure Network Status

1. Locate the newly added payer column(s)

2. For each facility:

   1. Toggle the payer In Network (INN) where applicable

   2. Leave the payer as Out of Network (OON) if not applicable

3. Toggle on the payer types your organization is in network with (e.g., Commercial, Managed Medicare, Managed Medicaid, Other), and toggle off any that do not apply.

Step 3: Upload a Contract

1. Click the Folder icon next to the INN chip

2. Select Add Contract

3. In the sidebar:

   • Select applicable contracted facilities

   • Set the expiry date or set no expiry date

   • Choose payer type:

     • Commercial

     • Managed Medicare

     • Managed Medicaid

     • Other

4. Select contract type

   • Levels (contract upload required)

   • PDPM (contract upload optional, as authorization reports are based on CMS Chapter 8 guidelines)

5. Upload your contract as a single PDF document

Manage Network Status on the Screener Tab

Enable the INN/OON Org-Wide Setting

This will toggle on the visual display of network status in the Screener tab.

1. Navigate to Admin Hub > Org Wide Settings

2. Toggle on Display INN/OON Status

   1. Select the facilities where you would like to enable this setting

View INN/OON referrals

On the Screener tab, each payer listed in the Primary Payer column will now show a status icon:

• Green checkmark: The primary payer is In Network.

• Gray X: The primary payer is Out of Network.

• No icon: The primary payer is Undetermined.

Filter by Network Status

Users can filter referrals by Network Status to quickly view In Network (INN), Out of Network (OON), or Undetermined referrals.

1. Click the filter icon in the Primary Payer column header.

2. Select Network Status.

3. Choose In Network, Out of Network, or Undetermined to filter the referral list.

Override a Payer’s Network Status

You can override the network status of a referral’s payer in two ways:

From the Screener tab:

1. Click the three dots on the far right of the referral

2. Select Edit payer details

3. Change Network Status to either In Network, Out of Network, or Undetermined

• From a lead's facesheet:

  1. Scroll to Insurance Information

  2. Select the pencil icon that says Edit

  3. Change Network Status to either In Network, Out of Network, or Undetermined