Overview
The new Payer tab feature supports management of payer changes for patients throughout their stay.
Accessing the Payers Tab (NEW)
Each patient record now includes a Payers tab, separate from the Episode of Care details.
To view payer information:
Open the patient profile→ Select the Payers tab→ Review the current payer assigned to the therapy track.
Here, you can see the active payer and manage payer updates as needed.
Scenario 1: Updating the Payer at the Start of a Therapy Track
This works the same way you currently update payer details for a new patient (see the screenshot on the next page).
Select Edit Details
Change the necessary fields: Payer Name, Start Date, or End Date
Save your changes
Scenario 2: Backdating a Payer Change (You learn about it after it happened)
Sometimes a payer change occurs before you’re made aware of it. In these cases, you may need to backdate the payer update.
To backdate:
Go to the Payers tab
Select Edit Details on the existing payer
Enter the correct end date (even if it’s in the past)
Example: Today is Nov. 14, but the payer actually ended Nov. 1
Click Save to apply changes and close the window
Click Add New Payer
Choose the new payer type
Set the new payer’s start date to the day after the previous end date
Example Nov. 2
⚠️ Important: There must be no gaps in insurance coverage; if there is a gap between coverage dates, any documentation submitted during that period is non-billable.
Scenario 3: Future Payer Change (You know the change is coming)
If you receive advance notice of an upcoming payer change:
Open the patient → Payers
Select the active payer and click Edit Details
From here, set the future end date for the current payer. Click Save.
In the Payer tab, click Add the new payer with a start date beginning the next day.
💡 Tip: If the change is far in advance, consider waiting until it is closer to the date—unexpected events (hospitalization, plan updates) may alter the insurance plan.
Recertification & Weekly Progress Note Cadence
Payer types can have different weekly Progress Note cadences based on Enterprise settings. Therapists should note the following after changing a payer type during an active certification period:
Review whether a recertification (re-cert) is required.
Example: Medicare A → Medicare B may require a re-cert because cadence rules differ
Ensure progress notes follow the correct payer-specific cadence.
Some commercial plans may share the same cadence and not require a recertification.
Always confirm the requirements for the new payer when making changes to ensure.
Documentation & Billing Considerations
1. Documents outside of Coverage
Any documentation that falls outside a payer’s active date range:
Will be marked Not Covered
Cannot be billed
Will not appear in billable items
2. Discharge Dated After Payer End Date:
If a discharge is scheduled after a payer’s end date:
Staff can write discharge documentation ( autosave available still)
But cannot submit it until the DOR updates the payer dates
This ensures all documents fall within an active billing period.
3. Forgetting to Add the Next Payer
If an end date is entered, but a new payer is not added:
Clinicians can still write notes (autosave protects them), BUT they cannot submit documentation, as this is a compliance safeguard
Once the new payer is added, all pending submissions will be allowed.
If you need any further support, please contact your customer success representative or message us Via the purple chat button. We're always here to help!